Provider Demographics
NPI:1962129189
Name:PERRY, DANA (FNP-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GEDDES
Mailing Address - State:SD
Mailing Address - Zip Code:57342-2201
Mailing Address - Country:US
Mailing Address - Phone:605-680-7223
Mailing Address - Fax:
Practice Address - Street 1:601 E 7TH ST
Practice Address - Street 2:
Practice Address - City:PLATTE
Practice Address - State:SD
Practice Address - Zip Code:57369-2123
Practice Address - Country:US
Practice Address - Phone:605-337-1501
Practice Address - Fax:605-337-3360
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily