Healthcare Provider Details

I. General information

NPI: 1588489769
Provider Name (Legal Business Name): DIRK ALEXANDER SAAR RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 CENTENNIAL BLVD
COLORADO SPRINGS CO
80907-4094
US

IV. Provider business mailing address

2765 RIDGE HAVEN DR
HARRISONBURG VA
22801-9614
US

V. Phone/Fax

Practice location:
  • Phone: 228-627-4304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN.1663402
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: