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NPI Code Detail

MEDICARE: MRS. SALLY ANN FREEMAN A.R.N.P., C.P.N.P.

MEDICARE: MRS. SALLY ANN FREEMAN A.R.N.P., C.P.N.P.
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 PractitionerARNP2814692FL
2363LP0200XPediatric Nurse PractitionerARNP2814692FL
3363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP2814692FL

General Provider Information

NPI Number : 1487738787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SALLY ANN FREEMAN A.R.N.P., C.P.N.P.
Provider Business Mailing Address
First Line : 18631 LE DAUPHINE PL
Second Line :
City : LUTZ
State : FL
Zip : 33558-2886
Country : US
Telephone Number : 813-789-3642
Fax Number : 813-932-0667
Provider Business Practice Location Address
First Line : 3191 CLAY MANGUM LN
Second Line :
City : TAMPA
State : FL
Zip : 33618-2501
Country : US
Telephone Number : 813-264-3807
Fax Number : 813-264-8931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 08/17/2011

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