Basic Information
| Provider Information | |||||||||
| NPI: | 1134182967 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENRY | ||||||||
| FirstName: | REGINA | ||||||||
| MiddleName: | BETH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 W 109TH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139420540 | ||||||||
| FaxNumber: | 6305289589 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 NE 54TH ST | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641184389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167990180 | ||||||||
| FaxNumber: | 6305289579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2006 | ||||||||
| LastUpdateDate: | 02/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 04-25932 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | R9J73 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.