Provider Demographics
NPI:1639816903
Name:FREENEY, ERICKA (CNA)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:FREENEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 JOHNSON CITY AVE
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5033
Mailing Address - Country:US
Mailing Address - Phone:682-227-7123
Mailing Address - Fax:
Practice Address - Street 1:2103 JOHNSON CITY AVE
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5033
Practice Address - Country:US
Practice Address - Phone:682-227-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA090443633747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant