Provider Demographics
NPI:1972313914
Name:BAGNALL, DANA M (CHHWC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:BAGNALL
Suffix:
Gender:F
Credentials:CHHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:EPHRAIM
Mailing Address - State:UT
Mailing Address - Zip Code:84627-1441
Mailing Address - Country:US
Mailing Address - Phone:435-314-8597
Mailing Address - Fax:
Practice Address - Street 1:236 E CENTER ST
Practice Address - Street 2:
Practice Address - City:EPHRAIM
Practice Address - State:UT
Practice Address - Zip Code:84627-1441
Practice Address - Country:US
Practice Address - Phone:435-314-8597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach