Healthcare Provider Details

I. General information

NPI: 1679180657
Provider Name (Legal Business Name): DANA NEARMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 TANEY AVE STE 105
FREDERICK MD
21702-5126
US

IV. Provider business mailing address

1475 TANEY AVE STE 105
FREDERICK MD
21702-5126
US

V. Phone/Fax

Practice location:
  • Phone: 240-446-7633
  • Fax:
Mailing address:
  • Phone: 240-656-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR176337
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR176337
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: