MEDICARE: DANA PERRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	374U00000X	Home Health Aide
3	174200000X	Meals Provider	WI
4	332U00000X	Home Delivered Meals	WI
5	172V00000X	Community Health Worker	WI
6	372600000X	Adult Companion	WI
7	171400000X	Health & Wellness Coach	WI

General Provider Information

NPI Number	:	1134768559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA PERRY

Provider Business Mailing Address
First Line	:	PO BOX 1111
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53095-8611
Country	:	US
Telephone Number	:	414-698-0990
Fax Number	:	855-853-8249

Provider Business Practice Location Address
First Line	:	PO BOX 1111
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53095-8611
Country	:	US
Telephone Number	:	414-698-0990
Fax Number	:	855-853-8249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2020
Last Update Date	:	12/09/2025

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Directions to “ DANA PERRY ” Practice Location

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