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NPI Code Detail

MEDICARE: MR. JONATHAN FREESE NP

MEDICARE: MR. JONATHAN FREESE NP
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
1363LF0000XFamily Nurse Practitioner25603TN

General Provider Information

NPI Number : 1194381186
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN FREESE NP
Provider Business Mailing Address
First Line : 2390 N OCOEE ST
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3850
Country : US
Telephone Number : 423-339-0300
Fax Number :
Provider Business Practice Location Address
First Line : 2390 N OCOEE ST
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3850
Country : US
Telephone Number : 423-339-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2019
Last Update Date : 03/15/2026

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