Provider Demographics
NPI:1528854916
Name:GERDES, DANA J
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:J
Last Name:GERDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 1ST ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:NE
Mailing Address - Zip Code:68378-3612
Mailing Address - Country:US
Mailing Address - Phone:970-779-4969
Mailing Address - Fax:
Practice Address - Street 1:402 1ST ST
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:NE
Practice Address - Zip Code:68378-3612
Practice Address - Country:US
Practice Address - Phone:970-779-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X, 372600000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion