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NPI Code Detail

MEDICARE: KELLIE DAHNA

MEDICARE: KELLIE DAHNA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1669731923
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE DAHNA
Provider Business Mailing Address
First Line : 6065 E LORING LANE
Second Line :
City : INVERNESS
State : FL
Zip : 34452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5000 LAKEWOOD RANCH BLVD
Second Line :
City : BRADENTON
State : FL
Zip : 34211-4909
Country : US
Telephone Number : 941-756-0690
Fax Number : 941-782-5721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2012
Last Update Date : 05/08/2012

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Directions to “ KELLIE DAHNA ” Practice Location

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