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NPI Code Detail

MEDICARE: KIMBERLY MELLENCAMP FREEMAN C.N.S.

MEDICARE: KIMBERLY MELLENCAMP FREEMAN C.N.S.
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
1364S00000XClinical Nurse Specialist28116944AIN

General Provider Information

NPI Number : 1720090947
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY MELLENCAMP FREEMAN C.N.S.
Provider Business Mailing Address
First Line : 2325 18TH ST
Second Line : SUITE 210
City : COLUMBUS
State : IN
Zip : 47201-5388
Country : US
Telephone Number : 812-375-0272
Fax Number : 812-375-1093
Provider Business Practice Location Address
First Line : 2325 18TH ST
Second Line : SUITE 210
City : COLUMBUS
State : IN
Zip : 47201-5388
Country : US
Telephone Number : 812-375-0272
Fax Number : 812-375-1093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 05/05/2016

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Directions to “ KIMBERLY MELLENCAMP FREEMAN C.N.S.” Practice Location

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