MEDICARE: DANA MARIE EISENMANN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN.430193	OH

General Provider Information

NPI Number	:	1457164410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA MARIE EISENMANN RN

Provider Business Mailing Address
First Line	:	5647 STRAUSSER ST NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44720-5561
Country	:	US
Telephone Number	:	330-631-1667
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 PATRIOT BLVD
Second Line	:
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-1167
Country	:	US
Telephone Number	:	330-631-1667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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