Provider Demographics
NPI:1992777825
Name:SEARS, DANA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:SEARS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 SUMERLIN DR
Mailing Address - Street 2:
Mailing Address - City:BUCKNER
Mailing Address - State:KY
Mailing Address - Zip Code:40010-8815
Mailing Address - Country:US
Mailing Address - Phone:502-648-3111
Mailing Address - Fax:
Practice Address - Street 1:3101 BRECKENRIDGE LN STE 2A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2742
Practice Address - Country:US
Practice Address - Phone:502-454-6000
Practice Address - Fax:502-454-6002
Is Sole Proprietor?:No
Enumeration Date:2006-02-04
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004056363LA2100X
KYAPN3004056363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78017530Medicaid
KYQ50711Medicare UPIN
KYNP00106Medicare PIN