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NPI Code Detail

MEDICARE: ATHENA FREEMAN FNP-C

MEDICARE: ATHENA FREEMAN FNP-C
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 Practitioner20155SC
2363LF0000XFamily Nurse PractitionerAP133998TX

General Provider Information

NPI Number : 1396193348
Entity Type Code : Individual
Provider Name (Legal Business Name) : ATHENA FREEMAN FNP-C
Provider Business Mailing Address
First Line : 6531 TALLOW WAY
Second Line :
City : CONVERSE
State : TX
Zip : 78109-4410
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7208 FM 78
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78244-1766
Country : US
Telephone Number : 210-666-0162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2016
Last Update Date : 04/17/2023

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Directions to “ ATHENA FREEMAN FNP-C” Practice Location

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