Provider Demographics
NPI:1801465521
Name:QAMOOS, DANA BLAIR (RN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:BLAIR
Last Name:QAMOOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 YORK AVE S APT 212
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4715
Mailing Address - Country:US
Mailing Address - Phone:651-216-5967
Mailing Address - Fax:
Practice Address - Street 1:1563 WHITE BEAR AVE N STE 102
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1616
Practice Address - Country:US
Practice Address - Phone:651-646-8771
Practice Address - Fax:651-646-8910
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN745019163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health