Healthcare Provider Details

I. General information

NPI: 1376192401
Provider Name (Legal Business Name): REGINA KAY FREEMAN MSN, RN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4726 CARDIOVASCULAR CENTER 1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109
US

IV. Provider business mailing address

9150 NORMANDY LN
YPSILANTI MI
48197-9284
US

V. Phone/Fax

Practice location:
  • Phone: 734-883-7776
  • Fax:
Mailing address:
  • Phone: 734-883-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number4704216975
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: