Provider Demographics
NPI:1598155947
Name:DYER, DAVID M (DNP, AGACNP-BC, RN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:DYER
Suffix:
Gender:M
Credentials:DNP, AGACNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-8332
Mailing Address - Country:US
Mailing Address - Phone:269-979-6310
Mailing Address - Fax:
Practice Address - Street 1:3790 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-8332
Practice Address - Country:US
Practice Address - Phone:269-979-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272318363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care