Provider Demographics
NPI:1639714215
Name:FREEMAN, TROY LEE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:LEE
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 COLLEENS CASK TER
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-5426
Mailing Address - Country:US
Mailing Address - Phone:770-605-9796
Mailing Address - Fax:
Practice Address - Street 1:7810 HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-3920
Practice Address - Country:US
Practice Address - Phone:770-473-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN194884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily