Provider Demographics
NPI:1801048863
Name:HUTCHINS-GOODWIN, REGINA (RN)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:
Last Name:HUTCHINS-GOODWIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:HUTCHINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:3101 BURNET AVENUE
Mailing Address - Street 2:ROOM 116
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3014
Mailing Address - Country:US
Mailing Address - Phone:513-357-7289
Mailing Address - Fax:513-357-7290
Practice Address - Street 1:3101 BURNET AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3014
Practice Address - Country:US
Practice Address - Phone:513-357-7289
Practice Address - Fax:513-357-7290
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 237261163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0502834Medicaid
OH0580027Medicaid