Provider Demographics
NPI:1477088813
Name:WHEELER, DANA (RN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:ANN
Other - Last Name:HENSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:E8610 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONDOVI
Mailing Address - State:WI
Mailing Address - Zip Code:54755-8791
Mailing Address - Country:US
Mailing Address - Phone:715-495-2270
Mailing Address - Fax:
Practice Address - Street 1:E8610 50TH AVE
Practice Address - Street 2:
Practice Address - City:MONDOVI
Practice Address - State:WI
Practice Address - Zip Code:54755-8791
Practice Address - Country:US
Practice Address - Phone:715-495-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16486230163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse