Provider Demographics
NPI:1528881182
Name:HAINER, DANA MARIE (NP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:HAINER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 NORSEMAN CT NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2430
Mailing Address - Country:US
Mailing Address - Phone:507-322-6564
Mailing Address - Fax:
Practice Address - Street 1:382 NORSEMAN CT NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2430
Practice Address - Country:US
Practice Address - Phone:507-322-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12247363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health