Individual
MS. REGINA FERN STAUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, APN, ACNP-BC
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-5748
Mailing address
737 LONG RD, XENIA, OH 45385-8462
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
COA14258-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095564
—
OH
Enumeration date
01/27/2013
Last updated
06/27/2014
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