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General NPI Number Information
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NPI Number | 1700530839
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Entity Type | Organization
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Legal Business Name | FREEDOM FAMILY HEALTH CARE, LLC
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 1701 7TH ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-5007
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Country | US
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Telephone | 304-485-9027
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Fax | 304-679-1012
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Provider Business Mailing Address
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Address Line | PO BOX 4178
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City | PARKERSBURG
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State | WV
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Zip | 26104-4178
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Country | US
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Telephone | 304-485-9027
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Fax | 304-679-1012
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | BARBARA LOTT
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Credential | NP-C
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Telephone | 304-485-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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