Provider Demographics
NPI:1780842369
Name:DAVIS, DANA MICHELLE (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:MICHELLE
Other - Last Name:HOCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2617 STATE HWY 19
Mailing Address - Street 2:
Mailing Address - City:IUAN HOE
Mailing Address - State:MN
Mailing Address - Zip Code:56142
Mailing Address - Country:US
Mailing Address - Phone:507-694-1840
Mailing Address - Fax:
Practice Address - Street 1:106 N 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1034
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1600564163W00000X
SDR036010164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse