Provider Demographics
NPI:1306230065
Name:MIRMAN, DANA RACHELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:RACHELLE
Last Name:MIRMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14223 E PREVAIL DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-7010
Mailing Address - Country:US
Mailing Address - Phone:217-260-1348
Mailing Address - Fax:
Practice Address - Street 1:18077 RIVER RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8303
Practice Address - Country:US
Practice Address - Phone:317-776-7028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28205432A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily