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1013952571

NPI Code Detail

MEDICARE: LISA H FREELAND CNM

MEDICARE: LISA H FREELAND CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0002X	High-Risk Obstetric Registered Nurse	RN60210577	WA
2	367A00000X	Advanced Practice Midwife	6836	WA
3	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	AP60210579	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G8908948	OTHER	WA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AP60210579	OTHER	WA	ADVANCED REGISTERED NURSE PRACTIONER
3	6836	OTHER	WA	CNM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	RN60210577	OTHER	WA	REGISTERED NURSE

General Provider Information

NPI Number	:	1013952571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA H FREELAND CNM

Provider Business Mailing Address
First Line	:	611 N IRON BRIDGE WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-4932
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-7806

Provider Business Practice Location Address
First Line	:	3919 N MAPLE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-1349
Country	:	US
Telephone Number	:	509-444-8200
Fax Number	:	509-444-7806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	03/07/2023

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Directions to “ LISA H FREELAND CNM” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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