Provider Demographics
NPI:1760071492
Name:WILLIAMS, DANA KERN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:KERN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:KERN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:2600 E 7TH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-4398
Mailing Address - Country:US
Mailing Address - Phone:704-372-7900
Mailing Address - Fax:
Practice Address - Street 1:2600 E 7TH ST UNIT A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4398
Practice Address - Country:US
Practice Address - Phone:704-372-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily