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General NPI Number Information
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NPI Number | 1891965927
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Entity Type | Individual
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Provider Name | DANA MICHELLE LOGSDON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 108 CEMETERY RD
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City | LEBANON
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State | KY
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Zip | 40033-1827
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Country | US
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Telephone | 270-692-2569
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Fax |
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Provider Business Mailing Address
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Address Line | 727 W. MAIN ST.
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City | LEBANON
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State | KY
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Zip | 40033
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Country | US
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Telephone | 270-692-2569
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Fax | 270-692-9987
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3005073
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3005073P
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License Number State | KY
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