Provider Demographics
NPI:1124782743
Name:COALSON, DANA GENE (RN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:GENE
Last Name:COALSON
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 1:6111 DUNVEGAN DR APT 305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6772
Mailing Address - Country:US
Mailing Address - Phone:470-755-1300
Mailing Address - Fax:
Practice Address - Street 1:6111 DUNVEGAN DR APT 305
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-6772
Practice Address - Country:US
Practice Address - Phone:470-755-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN300720163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical