Provider Demographics
NPI:1568483188
Name:DRISKELL, DANA S (ARNP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:S
Last Name:DRISKELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:S
Other - Last Name:MCDOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 NW MOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2507
Mailing Address - Country:US
Mailing Address - Phone:816-229-1198
Mailing Address - Fax:816-229-1198
Practice Address - Street 1:206 NW MOCK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2507
Practice Address - Country:US
Practice Address - Phone:816-229-1191
Practice Address - Fax:816-229-1198
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO054128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P59961Medicare UPIN
MOR14000004Medicare PIN