Provider Demographics
NPI:1437462033
Name:KOJIMA, FREDDIE N (ANP-BC)
Entity Type:Individual
Prefix:MR
First Name:FREDDIE
Middle Name:N
Last Name:KOJIMA
Suffix:
Gender:M
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 FRANK L DIGGS DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-6953
Mailing Address - Country:US
Mailing Address - Phone:865-647-3320
Mailing Address - Fax:865-647-3329
Practice Address - Street 1:129 FRANK L DIGGS DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-6953
Practice Address - Country:US
Practice Address - Phone:865-647-3320
Practice Address - Fax:865-647-3329
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14675363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health