Provider Demographics
NPI:1073358032
Name:EGNER, DANA J (RN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:J
Last Name:EGNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200961 STATE HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5917
Mailing Address - Country:US
Mailing Address - Phone:715-570-4102
Mailing Address - Fax:
Practice Address - Street 1:3214 MANNVILLE LN
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-8870
Practice Address - Country:US
Practice Address - Phone:715-570-4102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI138739163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty