Provider Demographics
NPI:1760915276
Name:FREEMAN, JULIE ANNE (FNP, BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 CAMDEN TRL
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-0825
Mailing Address - Country:US
Mailing Address - Phone:630-688-2772
Mailing Address - Fax:
Practice Address - Street 1:1204 E FIRE TOWER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4196
Practice Address - Country:US
Practice Address - Phone:252-744-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015722363LF0000X
NC5017696363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5017696OtherNURSE PRACTITIONER
IL209015722OtherSTATE OF ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION