MEDICARE: ALICE M FREEMAN B.S. NUTRITION, CNHP

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1134646029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE M FREEMAN B.S. NUTRITION, CNHP

Provider Business Mailing Address
First Line	:	705 TWINRIDGE LN STE 6
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5270
Country	:	US
Telephone Number	:	804-320-1220
Fax Number	:	804-320-1520

Provider Business Practice Location Address
First Line	:	705 TWINRIDGE LN STE 6
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5270
Country	:	US
Telephone Number	:	804-320-1220
Fax Number	:	804-320-1520

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

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	07/21/2022

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