Provider Demographics
NPI:1811547805
Name:MCKINNEY, DANA (CNP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7143 RAMBLEHURST RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3859
Mailing Address - Country:US
Mailing Address - Phone:419-270-0217
Mailing Address - Fax:
Practice Address - Street 1:1 SEAGATE STE 1960
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1522
Practice Address - Country:US
Practice Address - Phone:419-247-2880
Practice Address - Fax:419-247-2872
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024592363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care