Provider Demographics
NPI:1023106176
Name:FREEMAN, HOLLY K (CRNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:K
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 TOWNCENTER BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1835
Mailing Address - Country:US
Mailing Address - Phone:205-710-3838
Mailing Address - Fax:205-710-3839
Practice Address - Street 1:100 TOWNCENTER BLVD
Practice Address - Street 2:STE 300
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1835
Practice Address - Country:US
Practice Address - Phone:205-710-3838
Practice Address - Fax:205-710-3839
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-060328363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-060328OtherLICENSE