Provider Demographics
NPI:1144236548
Name:DEFREECE, JAMES I (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:I
Last Name:DEFREECE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-0748
Mailing Address - Country:US
Mailing Address - Phone:402-335-3594
Mailing Address - Fax:402-335-2004
Practice Address - Street 1:278 N 6TH STREET
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-0748
Practice Address - Country:US
Practice Address - Phone:402-335-3594
Practice Address - Fax:402-335-2004
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100027367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered