Provider Demographics
NPI:1376025460
Name:MICKLE, DANA KATHRYN (PA-C)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KATHRYN
Last Name:MICKLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:KATHRYN
Other - Last Name:STRIMBU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4605 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2246
Mailing Address - Country:US
Mailing Address - Phone:614-827-8700
Mailing Address - Fax:614-827-8701
Practice Address - Street 1:4605 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-2246
Practice Address - Country:US
Practice Address - Phone:614-827-8700
Practice Address - Fax:614-827-8701
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005598363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant