Healthcare Provider Details

I. General information

NPI: 1891314423
Provider Name (Legal Business Name): LAVONE FREEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W SAINT JAMES ST # B
TARBORO NC
27886-4931
US

IV. Provider business mailing address

507 NEWTON AVE
PRINCEVILLE NC
27886-9512
US

V. Phone/Fax

Practice location:
  • Phone: 252-702-3239
  • Fax:
Mailing address:
  • Phone: 252-702-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number7708581
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: