MEDICARE: MRS. DANA DEE PERCY REGISTERED NURSE

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	163WH0200X	Home Health Registered Nurse	RN289056	OH

General Provider Information

NPI Number	:	1346595261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA DEE PERCY REGISTERED NURSE

Provider Business Mailing Address
First Line	:	3352 CORAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-1908
Country	:	US
Telephone Number	:	419-787-3343
Fax Number	:

Provider Business Practice Location Address
First Line	:	3352 CORAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-1908
Country	:	US
Telephone Number	:	419-787-3343
Fax Number	:

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

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	07/17/2012

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