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NPI 1396542577

NPI 1396542577 : VICKIE FREESE : PAPILLION, NE

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General NPI Number Information
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    NPI Number           |    1396542577
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    Entity Type          |    Individual 
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    Provider Name        |    VICKIE FREESE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/26/2025
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    Last Update Date     |    02/26/2025
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Provider Practice Location Address
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    Address Line         |    1510 DURHAM DR 
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    City                 |    PAPILLION
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    State                |    NE
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    Zip                  |    68133-2859
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    Country              |    US
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    Telephone            |    402-990-0782
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15023 HOWE CT LOT 145 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68144-5543
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    Country              |    US
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    Telephone            |    402-960-3571
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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        |    372500000X
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    Taxonomy Name        |    Chore Provider
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    License Number       |    
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    License Number State |    
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