Provider Demographics
NPI:1134497597
Name:DAINACK, LOIS JEAN (RN)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:JEAN
Last Name:DAINACK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:787 CHAPARRAL DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1436
Mailing Address - Country:US
Mailing Address - Phone:435-668-2238
Mailing Address - Fax:435-668-2504
Practice Address - Street 1:1210 W CURLY HALLOW DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7080
Practice Address - Country:US
Practice Address - Phone:435-668-2238
Practice Address - Fax:435-668-1605
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT294003-3102163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator