Healthcare Provider Details

I. General information

NPI: 1730675893
Provider Name (Legal Business Name): PAMELA D FREEMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WELLNESS SOLUTION 360 2810 PEACHTREE INDUSTRIAL BLVD STE D
DULUTH GA
30097-0000
US

IV. Provider business mailing address

2810 PEACHTREE INDUSTRIAL BLVD STE D
DULUTH GA
30097-8142
US

V. Phone/Fax

Practice location:
  • Phone: 678-779-2655
  • Fax:
Mailing address:
  • Phone: 470-261-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201444
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: