Provider Demographics
NPI:1326765132
Name:FREEMAN, JEROME JAMES (BSN)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:JAMES
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 QUINN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3612
Mailing Address - Country:US
Mailing Address - Phone:774-274-1222
Mailing Address - Fax:
Practice Address - Street 1:5 QUINN ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-3612
Practice Address - Country:US
Practice Address - Phone:774-274-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2324631163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse