Provider Demographics
NPI:1326081332
Name:AYER, DANA FREDERICK
Entity Type:Individual
Prefix:MR
First Name:DANA
Middle Name:FREDERICK
Last Name:AYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 HOLLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3927
Mailing Address - Country:US
Mailing Address - Phone:719-264-7855
Mailing Address - Fax:719-264-7855
Practice Address - Street 1:320 E FONTANERO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7529
Practice Address - Country:US
Practice Address - Phone:719-471-0080
Practice Address - Fax:719-444-4866
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO130955163WX0200X
CORXN,NP 05-015363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WX0200XNursing Service ProvidersRegistered NurseOncology
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner