Provider Demographics
NPI:1164855136
Name:FREE, DANA ELIZABETH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ELIZABETH
Last Name:FREE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:WEST BLOCTON
Mailing Address - State:AL
Mailing Address - Zip Code:35184-0480
Mailing Address - Country:US
Mailing Address - Phone:205-938-9508
Mailing Address - Fax:
Practice Address - Street 1:345 MAGNOLIA STREET
Practice Address - Street 2:
Practice Address - City:WEST BLOCTON
Practice Address - State:AL
Practice Address - Zip Code:35184-0480
Practice Address - Country:US
Practice Address - Phone:205-938-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-090098363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics