Healthcare Provider Details

I. General information

NPI: 1578919502
Provider Name (Legal Business Name): ALEX LAUREN FREEMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 WELCH RD
PALO ALTO CA
94304-1503
US

IV. Provider business mailing address

300 PASTEUR DR RM G313
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-498-7353
  • Fax: 650-725-8375
Mailing address:
  • Phone: 650-498-7353
  • Fax: 650-725-8375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number95003150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: