Provider Demographics
NPI:1598051567
Name:FREESEMAN, JANE FRANCINE (RN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:FRANCINE
Last Name:FREESEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:FRANCINE
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:111 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2925
Mailing Address - Country:US
Mailing Address - Phone:319-352-2064
Mailing Address - Fax:319-352-2329
Practice Address - Street 1:111 10TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2925
Practice Address - Country:US
Practice Address - Phone:319-352-2064
Practice Address - Fax:319-352-2329
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA059148163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health