Healthcare Provider Details

I. General information

NPI: 1538894951
Provider Name (Legal Business Name): ALLISON LEIGH FREEMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON LEIGH FREEMAN

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/20/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3363 WHEELER RD STE 365
AUGUSTA GA
30909-3350
US

IV. Provider business mailing address

1011 WEST AVE
NORTH AUGUSTA SC
29841-3312
US

V. Phone/Fax

Practice location:
  • Phone: 706-432-8775
  • Fax:
Mailing address:
  • Phone: 404-219-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN265464
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: