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NPI Code Detail

MEDICARE: JANETTA K FREEMAN RNC, PAC

MEDICARE: JANETTA K FREEMAN RNC, PAC
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
1363AS0400XSurgical Physician Assistant1500649KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083700934
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANETTA K FREEMAN RNC, PAC
Provider Business Mailing Address
First Line : 505 N MAIN ST
Second Line :
City : ULYSSES
State : KS
Zip : 67880-2135
Country : US
Telephone Number : 620-356-1261
Fax Number :
Provider Business Practice Location Address
First Line : 505 N MAIN ST
Second Line :
City : ULYSSES
State : KS
Zip : 67880-2135
Country : US
Telephone Number : 620-356-1261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 11/09/2020

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