Basic Information
| Provider Information | |||||||||
| NPI: | 1528239704 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CNP, DNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DIMARCO | ||||||||
| OtherFirstName: | DANA | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13555 MOUNT EATON ROAD | ||||||||
| Address2: | |||||||||
| City: | DOYLESTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406663707 | ||||||||
| FaxNumber: | 3304584058 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 HERITAGE WOODS DRIVE | ||||||||
| Address2: | |||||||||
| City: | COPLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306660980 | ||||||||
| FaxNumber: | 3306663835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2008 | ||||||||
| LastUpdateDate: | 06/12/2013 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN323117 | OH | N | Nursing Service Providers | Registered Nurse | 363LG0600X | 09982 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.