Healthcare Provider Details

I. General information

NPI: 1164855136
Provider Name (Legal Business Name): DANA ELIZABETH FREE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11833 BELLE MEADE CIR
NORTHPORT AL
35475-4891
US

IV. Provider business mailing address

11833 BELLE MEADE CIR
NORTHPORT AL
35475-4891
US

V. Phone/Fax

Practice location:
  • Phone: 205-260-9281
  • Fax:
Mailing address:
  • Phone: 205-260-9281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-090098
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-090098
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: