Provider Demographics
NPI:1174989917
Name:ERMIS, DANA (NP-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:ERMIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 REGENCY PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7305
Mailing Address - Country:US
Mailing Address - Phone:175-399-0918
Mailing Address - Fax:817-539-9553
Practice Address - Street 1:309 REGENCY PKWY STE 205
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7305
Practice Address - Country:US
Practice Address - Phone:817-539-9091
Practice Address - Fax:817-539-9553
Is Sole Proprietor?:No
Enumeration Date:2016-01-09
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129971363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology