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General NPI Number Information
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NPI Number | 1093642514
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Entity Type | Individual
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Provider Name | KIMM FREEMAN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 750 TOWNPARK LN NW
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City | KENNESAW
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State | GA
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Zip | 30144-5824
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Country | US
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Telephone | 404-365-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 7092 ROSELAKE CIR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1683
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Country | US
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Telephone | 404-365-0966
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RPH023600
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1835P1400X
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Taxonomy Name | Pain Management Pharmacist
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License Number | RPH023600
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License Number State | GA
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