Provider Demographics
NPI:1417664731
Name:FREEMAN, SHANNA BRIANNE (APN)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:BRIANNE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 HOLLAND JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2022
Mailing Address - Country:US
Mailing Address - Phone:423-619-5322
Mailing Address - Fax:
Practice Address - Street 1:1028 HOLLAND JOHNSON RD
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-2022
Practice Address - Country:US
Practice Address - Phone:423-619-5322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32878363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care