Provider Demographics
NPI:1346957255
Name:WIESENFELD, DANA HILARY (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:HILARY
Last Name:WIESENFELD
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 1:3140 ARBORWOODS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5289
Mailing Address - Country:US
Mailing Address - Phone:404-642-5336
Mailing Address - Fax:
Practice Address - Street 1:960 N POINT PKWY STE 120
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8892
Practice Address - Country:US
Practice Address - Phone:770-274-9511
Practice Address - Fax:404-642-5336
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN264559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty