Provider Demographics
NPI:1114405198
Name:FREEMAN, QUANISHA
Entity Type:Individual
Prefix:
First Name:QUANISHA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FISHING HOLE TRL APT 201
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2173
Mailing Address - Country:US
Mailing Address - Phone:910-527-3624
Mailing Address - Fax:
Practice Address - Street 1:909 FISHING HOLE TRL APT 201
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2173
Practice Address - Country:US
Practice Address - Phone:910-527-3624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula