Provider Demographics
NPI:1750062881
Name:UJOR, DANA LINDSAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LINDSAY
Last Name:UJOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:LINDSAY
Other - Last Name:THERIAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1228 DOLAN DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-3804
Mailing Address - Country:US
Mailing Address - Phone:234-650-3681
Mailing Address - Fax:
Practice Address - Street 1:1228 DOLAN DR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-3804
Practice Address - Country:US
Practice Address - Phone:234-650-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI326209-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse