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General NPI Number Information
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NPI Number | 1093266470
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Entity Type | Individual
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Provider Name | MONICA FREEMAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 865 BLANDING BLVD
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City | ORANGE PARK
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State | FL
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Zip | 32065-8917
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Country | US
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Telephone | 904-276-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 COUNTY ROAD 220 APT 3108
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-9114
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Country | US
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Telephone | 660-624-4465
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2007002622
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95026969
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016036906
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11028996
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License Number State | FL
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