Provider Demographics
NPI:1720045461
Name:KATZ, DANA L (FNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:KATZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100523
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-0523
Mailing Address - Country:US
Mailing Address - Phone:843-669-5162
Mailing Address - Fax:843-667-4573
Practice Address - Street 1:137 CEDAR DR
Practice Address - Street 2:
Practice Address - City:SAINT STEPHEN
Practice Address - State:SC
Practice Address - Zip Code:29479-3371
Practice Address - Country:US
Practice Address - Phone:843-567-4000
Practice Address - Fax:843-567-3000
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0511Medicaid
SCNP0511Medicaid
P51225Medicare UPIN
SCP512255281Medicare PIN
P51225Medicare UPIN