Healthcare Provider Details

I. General information

NPI: 1962129189
Provider Name (Legal Business Name): DANA PERRY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 7TH ST
PLATTE SD
57369-2123
US

IV. Provider business mailing address

702 MAIN AVE
GEDDES SD
57342-2201
US

V. Phone/Fax

Practice location:
  • Phone: 605-337-1501
  • Fax: 605-337-3360
Mailing address:
  • Phone: 605-680-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP002559
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: