Provider Demographics
NPI:1316257017
Name:DAHLQUIST, DENA MARIE (ARNP-C)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:MARIE
Last Name:DAHLQUIST
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 GULF DR
Mailing Address - Street 2:APT 101
Mailing Address - City:HOLMES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34217-1175
Mailing Address - Country:US
Mailing Address - Phone:941-773-7617
Mailing Address - Fax:
Practice Address - Street 1:3909 E BAY DR
Practice Address - Street 2:STE 100
Practice Address - City:HOLMES BEACH
Practice Address - State:FL
Practice Address - Zip Code:34217-1997
Practice Address - Country:US
Practice Address - Phone:941-778-1007
Practice Address - Fax:941-778-9256
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3175322363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
EC238XMedicare PIN