Provider Demographics
NPI:1003430828
Name:VASNELIS, DANA MARIE (MSN)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MARIE
Last Name:VASNELIS
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:45 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-2108
Mailing Address - Country:US
Mailing Address - Phone:862-823-2831
Mailing Address - Fax:
Practice Address - Street 1:329 MAIN RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9729
Practice Address - Country:US
Practice Address - Phone:973-334-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00986100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily