Healthcare Provider Details

I. General information

NPI: 1811547805
Provider Name (Legal Business Name): DANA MCKINNEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 MONROE ST UNIT 210
SYLVANIA OH
43560-2737
US

IV. Provider business mailing address

5700 MONROE ST UNIT 210
SYLVANIA OH
43560-2737
US

V. Phone/Fax

Practice location:
  • Phone: 567-585-0490
  • Fax: 567-585-0491
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.024592
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: