Provider Demographics
NPI:1912111014
Name:HELLEBUSCH, DANA L (RN, MSN, CDE, FNP-BC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:HELLEBUSCH
Suffix:
Gender:F
Credentials:RN, MSN, CDE, FNP-BC
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:L
Other - Last Name:HELLEBUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1351 JEFFERSON ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-6449
Mailing Address - Country:US
Mailing Address - Phone:636-235-4858
Mailing Address - Fax:877-669-0615
Practice Address - Street 1:1351 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-6441
Practice Address - Country:US
Practice Address - Phone:636-235-4858
Practice Address - Fax:877-669-0615
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113794163WD0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429908205Medicaid
MO429908205Medicaid
Q78686Medicare UPIN