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MRS. SHAUNDA T FREEMAN FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1265510440
Individual Registrant:MRS. SHAUNDA T FREEMAN FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2045 HWY 61 NORTH PORT GIBSON, MS 39150-4262 US
Tel: 601-437-3050 Fax: 601-437-3051
Tel: 601-437-3050 Fax: 601-437-3051
Contact information for business:
PO BOX 741 PORT GIBSON, MS 39150-0741 US
Tel: 601-437-3050 Fax: 601-437-3051
Tel: 601-437-3050 Fax: 601-437-3051
Registration Information:
NPI: 1265510440
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | MS | R864672 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 02975221 | MS | 05 |
