Provider Demographics
NPI:1528188984
Name:DANA L. SEARS, ARNP, LLC
Entity Type:Organization
Organization Name:DANA L. SEARS, ARNP, LLC
Other - Org Name:MOBILE MEDICAL CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:502-648-3111
Mailing Address - Street 1:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-1126
Mailing Address - Country:US
Mailing Address - Phone:502-648-3111
Mailing Address - Fax:502-716-6113
Practice Address - Street 1:2529 SIX MILE LN
Practice Address - Street 2:SUITE 105
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2934
Practice Address - Country:US
Practice Address - Phone:502-648-3111
Practice Address - Fax:502-716-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004056363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78017530Medicaid
KY78017530Medicaid
KYNP00106Medicare PIN