MEDICARE: MS. LAURA FREEMAN CEI L.P.N.

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	164W00000X	Licensed Practical Nurse	0002065379	VA

General Provider Information

NPI Number	:	1316101678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA FREEMAN CEI L.P.N.

Provider Business Mailing Address
First Line	:	2000 RIVERSIDE DR
Second Line	:	APT. 15G
City	:	RICHMOND
State	:	VA
Zip	:	23225-3621
Country	:	US
Telephone Number	:	804-938-2615
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 RIVERSIDE DR
Second Line	:	APT. 15G
City	:	RICHMOND
State	:	VA
Zip	:	23225-3621
Country	:	US
Telephone Number	:	804-938-2615
Fax Number	:

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/16/2008

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