Healthcare Provider Details

I. General information

NPI: 1467375451
Provider Name (Legal Business Name): DANA OMERZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 E MARKET ST
WARREN OH
44483-6638
US

IV. Provider business mailing address

4752 HOAGLAND BLACKSTUB RD
CORTLAND OH
44410-9507
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-7212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0042728
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: