Healthcare Provider Details

I. General information

NPI: 1346595261
Provider Name (Legal Business Name): DANA DEE PERCY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3352 CORAL AVE
TOLEDO OH
43623-1908
US

IV. Provider business mailing address

3352 CORAL AVE
TOLEDO OH
43623-1908
US

V. Phone/Fax

Practice location:
  • Phone: 419-787-3343
  • Fax:
Mailing address:
  • Phone: 419-787-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN289056
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: