MEDICARE: MRS. DANA LINDSAY UJOR LPN

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	164W00000X	Licensed Practical Nurse	326209-31	WI

General Provider Information

NPI Number	:	1750062881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA LINDSAY UJOR LPN

Provider Business Mailing Address
First Line	:	1228 DOLAN DR
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-3804
Country	:	US
Telephone Number	:	234-650-3681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 DOLAN DR
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-3804
Country	:	US
Telephone Number	:	234-650-3681
Fax Number	:

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

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	08/28/2023

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