Healthcare Provider Details

I. General information

NPI: 1356803688
Provider Name (Legal Business Name): DANA MICHELLE DENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 11/27/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 METCALF AVE
OVERLAND PARK KS
66223-1200
US

IV. Provider business mailing address

5730 EXECUTIVE DR STE 230
CATONSVILLE MD
21228-1762
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-2080
  • Fax: 913-945-2095
Mailing address:
  • Phone: 913-945-2080
  • Fax: 913-945-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2019010652
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-80472052
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: