Healthcare Provider Details

I. General information

NPI: 1386016236
Provider Name (Legal Business Name): JULIE FREEMAN NUTRITION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2015
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 GATHERING SQUARE CT
FUQUAY VARINA NC
27526-4356
US

IV. Provider business mailing address

2412 GATHERING SQUARE CT
FUQUAY VARINA NC
27526-4356
US

V. Phone/Fax

Practice location:
  • Phone: 781-237-9016
  • Fax: 781-236-6126
Mailing address:
  • Phone: 781-237-9016
  • Fax: 781-236-6126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number162
License Number StateMA

VIII. Authorized Official

Name: MS. JULIE ANNE FREEMAN
Title or Position: LICENSED NUTRITIONIST
Credential: LD, RD
Phone: 781-237-9016