Provider Demographics
NPI:1780108860
Name:DYER, DINA MARIE (APRN)
Entity type:Individual
Prefix:MS
First Name:DINA
Middle Name:MARIE
Last Name:DYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 WYNDHAM N
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-8376
Mailing Address - Country:US
Mailing Address - Phone:504-577-0411
Mailing Address - Fax:
Practice Address - Street 1:1500 LAFAYETTE ST STE 141
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5758
Practice Address - Country:US
Practice Address - Phone:504-363-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA244038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty