Provider Demographics
NPI:1366439010
Name:FREEMAN, VIVIANLE B (OD)
Entity Type:Individual
Prefix:DR
First Name:VIVIANLE
Middle Name:B
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-5320
Mailing Address - Country:US
Mailing Address - Phone:402-452-7854
Mailing Address - Fax:
Practice Address - Street 1:106 MEYER AVE BLDG 166
Practice Address - Street 2:
Practice Address - City:OFFUTT AFB
Practice Address - State:NE
Practice Address - Zip Code:68113-2000
Practice Address - Country:US
Practice Address - Phone:402-292-0396
Practice Address - Fax:402-292-2263
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-973-TA-538152W00000X
GAOPT-001853152W00000X
NE1313152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist