Healthcare Provider Details

I. General information

NPI: 1881189389
Provider Name (Legal Business Name): SHAROLETTE S FREEMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107B FAHM ST
SAVANNAH GA
31401-2391
US

IV. Provider business mailing address

7 HUMMER CT
SAVANNAH GA
31405-9468
US

V. Phone/Fax

Practice location:
  • Phone: 912-651-2253
  • Fax:
Mailing address:
  • Phone: 912-228-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number240266
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNCO-000001
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: