Provider Demographics
NPI:1649014580
Name:DANNER, ANA ROSE
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ROSE
Last Name:DANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 WESTBROOK DR APT 315
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-2027
Mailing Address - Country:US
Mailing Address - Phone:317-450-8587
Mailing Address - Fax:
Practice Address - Street 1:2101 E COLISEUM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-1499
Practice Address - Country:US
Practice Address - Phone:260-257-6831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program