Healthcare Provider Details

I. General information

NPI: 1740436518
Provider Name (Legal Business Name): ALANA DAWN KLASE-FREEMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3127
US

IV. Provider business mailing address

5500 MARYLAND WAY SUITE 400
BRENTWOOD TN
37027-4948
US

V. Phone/Fax

Practice location:
  • Phone: 719-520-7080
  • Fax: 719-520-7086
Mailing address:
  • Phone: 888-830-4255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0004450
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: