Provider Demographics
NPI:1861016479
Name:FREEMAN, HAILEY NICOLE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:NICOLE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:HAILEY
Other - Middle Name:NICOLE
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3501 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3406
Mailing Address - Country:US
Mailing Address - Phone:515-271-5047
Mailing Address - Fax:515-271-5058
Practice Address - Street 1:3501 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3406
Practice Address - Country:US
Practice Address - Phone:515-271-5047
Practice Address - Fax:515-271-5058
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-31
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist