Provider Demographics
NPI:1376946756
Name:FREEMAN, AMI (RN)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 44TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3215
Mailing Address - Country:US
Mailing Address - Phone:806-281-4636
Mailing Address - Fax:
Practice Address - Street 1:5005 44TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3215
Practice Address - Country:US
Practice Address - Phone:806-281-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX780771163WC0200X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management