Provider Demographics
NPI:1326369919
Name:FREEMAN, AMY MOXLEY (APRN, MSN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MOXLEY
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:APRN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 W DEKALB ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-4162
Mailing Address - Country:US
Mailing Address - Phone:803-432-8622
Mailing Address - Fax:803-432-8624
Practice Address - Street 1:1045 W DEKALB ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-4162
Practice Address - Country:US
Practice Address - Phone:803-432-8622
Practice Address - Fax:803-432-8624
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN4119363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care