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NPI Code Detail

MEDICARE: DIANE FREEMAN

MEDICARE: DIANE FREEMAN
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
1171M00000XCase Manager/Care CoordinatorOH

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 : 1184346868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE FREEMAN
Provider Business Mailing Address
First Line : 11470 COUNTY ROAD 1
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-7010
Country : US
Telephone Number : 740-451-0074
Fax Number :
Provider Business Practice Location Address
First Line : 11470 COUNTY ROAD 1
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-7010
Country : US
Telephone Number : 740-451-0074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2022
Last Update Date : 09/19/2022

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