Provider Demographics
NPI:1538563028
Name:BEBBER, DANA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:BEBBER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:PEACOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5145 WHEELER WAY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-4438
Mailing Address - Country:US
Mailing Address - Phone:407-212-9252
Mailing Address - Fax:
Practice Address - Street 1:5041 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8916
Practice Address - Country:US
Practice Address - Phone:850-433-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP180866363LA2200X
VA0024174554363LA2200X
FLAPRN11003137363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health