Provider Demographics
NPI:1497552608
Name:SAMMONS, DALENA
Entity type:Individual
Prefix:
First Name:DALENA
Middle Name:
Last Name:SAMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N VINE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:51534-1541
Mailing Address - Country:US
Mailing Address - Phone:531-495-2092
Mailing Address - Fax:
Practice Address - Street 1:207 N VINE ST APT 1
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-1541
Practice Address - Country:US
Practice Address - Phone:531-495-2092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant