Provider Demographics
NPI:1902523665
Name:THORDSEN, DANA C (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:C
Last Name:THORDSEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:IA
Mailing Address - Zip Code:52309-9475
Mailing Address - Country:US
Mailing Address - Phone:515-210-2026
Mailing Address - Fax:
Practice Address - Street 1:600 7TH ST SE STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2125
Practice Address - Country:US
Practice Address - Phone:319-378-9356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA171591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily