Healthcare Provider Details

I. General information

NPI: 1043338544
Provider Name (Legal Business Name): KAREN FREEMAN MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10105 BANBURRY CROSS DRIVE SUITE 370
LAS VEGAS NV
89144-6649
US

IV. Provider business mailing address

DESERT VALLEY PEDIATRICS, L.L.P. 10105 BANBURRY CROSS DRIVE, SUITE 370
LAS VEGAS NV
89144-6649
US

V. Phone/Fax

Practice location:
  • Phone: 702-260-4525
  • Fax: 702-869-0133
Mailing address:
  • Phone: 702-260-4525
  • Fax: 702-869-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN135409
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP2285
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: