Provider Demographics
NPI:1649043191
Name:ZEGA, DANA (APRN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:ZEGA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18269 PLATINUM DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:IN
Mailing Address - Zip Code:46356-2464
Mailing Address - Country:US
Mailing Address - Phone:219-793-2488
Mailing Address - Fax:
Practice Address - Street 1:704 S STATE ROAD 2
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:IN
Practice Address - Zip Code:46341-8801
Practice Address - Country:US
Practice Address - Phone:219-996-2641
Practice Address - Fax:219-996-7684
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014594A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily