Provider Demographics
NPI:1457922973
Name:REITZAMMER, DANA G (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:G
Last Name:REITZAMMER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:GAIL
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5600 CYPRESS ST STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7540
Mailing Address - Country:US
Mailing Address - Phone:318-536-0388
Mailing Address - Fax:318-536-0394
Practice Address - Street 1:5600 CYPRESS ST STE 4
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7540
Practice Address - Country:US
Practice Address - Phone:318-536-0388
Practice Address - Fax:318-536-0394
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221055363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology