Provider Demographics
NPI:1841799921
Name:FREEMAN, QUEEN (LPN)
Entity Type:Individual
Prefix:
First Name:QUEEN
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7071 MIDWAY TER UNIT 2
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-4344
Mailing Address - Country:US
Mailing Address - Phone:352-286-6020
Mailing Address - Fax:
Practice Address - Street 1:7071 MIDWAY TER UNIT 2
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-4344
Practice Address - Country:US
Practice Address - Phone:352-286-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5164834164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse