MEDICARE: MS. ALANA DAWN KLASE-FREEMAN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.0004450	CO

General Provider Information

NPI Number	:	1740436518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALANA DAWN KLASE-FREEMAN PA

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY
Second Line	:	SUITE 400
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4948
Country	:	US
Telephone Number	:	888-830-4255
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 INTERNATIONAL CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3127
Country	:	US
Telephone Number	:	719-520-7080
Fax Number	:	719-520-7086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	05/16/2016

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