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General NPI Number Information
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NPI Number | 1457633745
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Entity Type | Individual
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Provider Name | MARY P FREEMAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 5501 ROOSEVELT BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32244-2345
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Country | US
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Telephone | 904-683-9962
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Fax | 904-683-9640
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Provider Business Mailing Address
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Address Line | 5501 ROOSEVELT BLVD ST VINCENT'SFIRST CARE WALK-IN EXPRESS
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City | JACKSONVILLE
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State | FL
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Zip | 32244-2345
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Country | US
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Telephone | 904-683-9962
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Fax | 904-683-9640
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9250100
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License Number State | FL
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