Provider Demographics
NPI:1861743122
Name:DAHL, NANCY LOUISE (APRN)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LOUISE
Last Name:DAHL
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 1:2435 BEXLEY VILLAGE DR # 200
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-2721
Mailing Address - Country:US
Mailing Address - Phone:813-467-4771
Mailing Address - Fax:
Practice Address - Street 1:2435 BEXLEY VILLAGE DR # 200
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-2721
Practice Address - Country:US
Practice Address - Phone:813-467-4771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9170172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily