Provider Demographics
NPI:1275813396
Name:FREEMAN, NARCISSES DENISE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:NARCISSES
Middle Name:DENISE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-4433
Mailing Address - Country:US
Mailing Address - Phone:419-241-6091
Mailing Address - Fax:
Practice Address - Street 1:114 N HAWLEY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-4433
Practice Address - Country:US
Practice Address - Phone:419-241-6091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401204670211374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH401204670211OtherSTNA