Provider Demographics
NPI:1003287947
Name:GRENIER, DANA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:GRENIER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 PEACHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4626
Mailing Address - Country:US
Mailing Address - Phone:307-352-6689
Mailing Address - Fax:
Practice Address - Street 1:2706 ANKENY WAY
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5649
Practice Address - Country:US
Practice Address - Phone:307-352-6689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY23508-1446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily