Healthcare Provider Details

I. General information

NPI: 1770735227
Provider Name (Legal Business Name): PAMELA RENEE FREEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COLORADO BLVD 318
DENVER CO
80206-4084
US

IV. Provider business mailing address

4944 MARSH HARRIER AVE
GRAND PRAIRIE TX
75052-3057
US

V. Phone/Fax

Practice location:
  • Phone: 866-801-9492
  • Fax: 800-539-0098
Mailing address:
  • Phone: 972-602-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number648112
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number648112
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number648112
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number648112
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: