Provider Demographics
NPI:1386732014
Name:BRANNON, DANA A (ARNP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:A
Last Name:BRANNON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:A
Other - Last Name:KEHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0009
Mailing Address - Country:US
Mailing Address - Phone:541-676-9133
Mailing Address - Fax:541-676-2905
Practice Address - Street 1:1020 ANDERSON DR
Practice Address - Street 2:SUITE 203
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1055
Practice Address - Country:US
Practice Address - Phone:360-533-6063
Practice Address - Fax:360-533-2204
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004226363LF0000X
OR201705445NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9629130Medicaid
S71187Medicare UPIN
WA9629130Medicaid
G8863745Medicare PIN