Healthcare Provider Details

I. General information

NPI: 1346590007
Provider Name (Legal Business Name): DANA ALLEN MCLAREN MIDWIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 COLUMBINE AVE
COLORADO SPRINGS CO
80904-2784
US

IV. Provider business mailing address

937 COLUMBINE AVE
COLORADO SPRINGS CO
80904-2784
US

V. Phone/Fax

Practice location:
  • Phone: 719-645-5552
  • Fax: 719-358-8397
Mailing address:
  • Phone: 719-645-5552
  • Fax: 719-358-8397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: