Provider Demographics
NPI:1376059105
Name:NYE, DANA KRISTEN (MA, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KRISTEN
Last Name:NYE
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4942 CALDWELL MILL LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4506
Mailing Address - Country:US
Mailing Address - Phone:405-408-7799
Mailing Address - Fax:
Practice Address - Street 1:3605 RATLIFF RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-4512
Practice Address - Country:US
Practice Address - Phone:205-956-2184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist