MEDICARE: DESIREE SARA FREEMAN RN

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	163W00000X	Registered Nurse	085099-21	NH

General Provider Information

NPI Number	:	1538981931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE SARA FREEMAN RN

Provider Business Mailing Address
First Line	:	17 N MEADOW RD
Second Line	:
City	:	AMHERST
State	:	NH
Zip	:	03031-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 N MEADOW RD
Second Line	:
City	:	AMHERST
State	:	NH
Zip	:	03031-2616
Country	:	US
Telephone Number	:	603-809-7970
Fax Number	:

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

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	10/28/2024

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