Healthcare Provider Details

I. General information

NPI: 1578240545
Provider Name (Legal Business Name): DANA ANN KAPCIO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14585 HAZEL DELL PKWY
CARMEL IN
46033-9401
US

IV. Provider business mailing address

1525 GENNTOWN DR STE A2
LEBANON OH
45036-7323
US

V. Phone/Fax

Practice location:
  • Phone: 317-214-5030
  • Fax:
Mailing address:
  • Phone: 513-821-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009925RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: