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General NPI Number Information
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NPI Number | 1205650504
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE FREEBORN AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 2175 ROSALINE AVE
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City | REDDING
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State | CA
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Zip | 96001-2549
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Country | US
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Telephone | 530-225-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 PIONEER DR
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City | REDDING
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State | CA
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Zip | 96001-0204
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Country | US
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Telephone | 530-392-2944
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95032995
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 95098963
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License Number State | CA
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