Provider Demographics
NPI:1659691657
Name:PAULEY PERSINGER, DANA NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:NICOLE
Last Name:PAULEY PERSINGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DANA
Other - Middle Name:NICOLE
Other - Last Name:PAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:25 GARTON PLZ
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-2128
Mailing Address - Country:US
Mailing Address - Phone:304-517-1115
Mailing Address - Fax:304-517-1119
Practice Address - Street 1:25 GARTON PLZ
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-2128
Practice Address - Country:US
Practice Address - Phone:304-517-1115
Practice Address - Fax:304-517-1119
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.010976207Q00000X
WV2948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine