Provider Demographics
NPI:1407031297
Name:HULL, DANA C (CRNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:C
Last Name:HULL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:C
Other - Last Name:LECKRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2332
Practice Address - Country:US
Practice Address - Phone:717-765-5086
Practice Address - Fax:717-762-4551
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA867633OtherMEDICARE GROUP #
PA25-1716306OtherHEALTHNET/TRICARE
PA102076637 0001Medicaid
PASP009156OtherCRNP LICENSE
PARN530373LOtherRN LICENSE
PARN530373LOtherRN LICENSE
PASP009156OtherCRNP LICENSE