Healthcare Provider Details

I. General information

NPI: 1588846539
Provider Name (Legal Business Name): THELMA LOUISE FREEHLING LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2007
Last Update Date: 12/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 E MAIN ST
SOUTH AMHERST OH
44001-2838
US

IV. Provider business mailing address

27857 STATE ROUTE 58
WELLINGTON OH
44090-9021
US

V. Phone/Fax

Practice location:
  • Phone: 440-668-8064
  • Fax:
Mailing address:
  • Phone: 440-668-8064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN070840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: