Provider Demographics
NPI:1518357920
Name:LANMON-FREEMAN, JUNIPER JEANINE (DEM,LM)
Entity Type:Individual
Prefix:
First Name:JUNIPER
Middle Name:JEANINE
Last Name:LANMON-FREEMAN
Suffix:
Gender:F
Credentials:DEM,LM
Other - Prefix:
Other - First Name:JUNIPER
Other - Middle Name:JEANINE
Other - Last Name:LANMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DEM
Mailing Address - Street 1:901 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-3235
Mailing Address - Country:US
Mailing Address - Phone:907-299-4399
Mailing Address - Fax:541-507-0911
Practice Address - Street 1:901 S 12TH ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3235
Practice Address - Country:US
Practice Address - Phone:907-299-4399
Practice Address - Fax:541-507-0911
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10166530176B00000X
ORDEM-LD-10214471176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife