Provider Demographics
NPI:1770338782
Name:MCQUEEN, DAKOTA G (PA)
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:G
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:WETMORE
Mailing Address - State:KS
Mailing Address - Zip Code:66550-9303
Mailing Address - Country:US
Mailing Address - Phone:785-364-7675
Mailing Address - Fax:
Practice Address - Street 1:532 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:WETMORE
Practice Address - State:KS
Practice Address - Zip Code:66550-9303
Practice Address - Country:US
Practice Address - Phone:785-364-7675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant