Provider Demographics
NPI:1477859932
Name:FREEMAN, CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
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 1:450 WHITEFISH TRL
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-6752
Mailing Address - Country:US
Mailing Address - Phone:406-752-4998
Mailing Address - Fax:
Practice Address - Street 1:9705 LOST PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MT
Practice Address - Zip Code:59925-9844
Practice Address - Country:US
Practice Address - Phone:406-858-2339
Practice Address - Fax:406-858-2356
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN15982163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool