Healthcare Provider Details

I. General information

NPI: 1912111014
Provider Name (Legal Business Name): DANA L HELLEBUSCH RN, MSN, CDE, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANA L HELLEBUSCH

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 02/20/2024
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 JEFFERSON ST
WASHINGTON MO
63090-6441
US

IV. Provider business mailing address

1351 JEFFERSON ST STE 208
WASHINGTON MO
63090-6449
US

V. Phone/Fax

Practice location:
  • Phone: 636-235-4858
  • Fax: 877-669-0615
Mailing address:
  • Phone: 636-235-4858
  • Fax: 877-669-0615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number113794
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113794
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: