Healthcare Provider Details

I. General information

NPI: 1073836482
Provider Name (Legal Business Name): DANA ELIZABETH ALLEN FNP,CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S MULBERRY AVE
BUTLER AL
36904-2813
US

IV. Provider business mailing address

2150 TIMBERLANE RD
BUTLER AL
36904-3945
US

V. Phone/Fax

Practice location:
  • Phone: 205-459-4026
  • Fax:
Mailing address:
  • Phone: 205-459-2659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-059691
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: