MEDICARE: DANO K HEATWOLE CRNP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024179429	VA
2	363L00000X	Nurse Practitioner	RN620495	PA
3	363L00000X	Nurse Practitioner	SP016257	PA
4	363LF0000X	Family Nurse Practitioner	SP016257	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R620495	OTHER	PA	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235589078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANO K HEATWOLE CRNP

Provider Business Mailing Address
First Line	:	1209 RICHMOND AVE
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-5069
Country	:	US
Telephone Number	:	540-885-0629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 RICHMOND AVE
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-5069
Country	:	US
Telephone Number	:	540-885-0629
Fax Number	:

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

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	09/08/2025

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