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General NPI Number Information
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NPI Number | 1639725823
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Entity Type | Individual
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Provider Name | SAMANTHA EUGENIA FREEMAN NP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 1220 E REPUBLIC RD
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7209
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Country | US
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Telephone | 417-823-4893
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Fax |
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Provider Business Mailing Address
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Address Line | 1377 MONTAGUE RD
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City | HIGHLANDVILLE
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State | MO
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Zip | 65669-8180
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Country | US
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Telephone | 417-559-3759
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2019031432
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License Number State | MO
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