Provider Demographics
NPI:1871241075
Name:FREEMAN, CHRISTA DAWN (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:DAWN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HIGHWAY 416 W
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-8871
Mailing Address - Country:US
Mailing Address - Phone:812-568-5282
Mailing Address - Fax:
Practice Address - Street 1:901 HIGHWAY 416 W
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-8871
Practice Address - Country:US
Practice Address - Phone:812-568-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28152181A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8433843384OtherMEDICARE
KY8433843384Medicaid
IN8433843384OtherMEDICARE
IN8433843384Medicaid