Provider Demographics
NPI:1568414837
Name:FREEMAN, DORIAN PATRICE (RNC, WHNP)
Entity Type:Individual
Prefix:MS
First Name:DORIAN
Middle Name:PATRICE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 TREE LANE RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6782
Mailing Address - Country:US
Mailing Address - Phone:770-972-0330
Mailing Address - Fax:770-985-2683
Practice Address - Street 1:1700 TREE LANE RD
Practice Address - Street 2:SUITE 290
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-972-0330
Practice Address - Fax:770-985-2683
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN128290363L00000X, 363LW0102X, 364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN128290OtherPROFESSIONAL NURSE LICENS