Provider Demographics
NPI:1134524564
Name:FREEMAN-ATKINS, MARCIA ANN-MARIE
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ANN-MARIE
Last Name:FREEMAN-ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13305 DURKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4622
Mailing Address - Country:US
Mailing Address - Phone:216-205-5668
Mailing Address - Fax:
Practice Address - Street 1:13305 DURKEE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-4622
Practice Address - Country:US
Practice Address - Phone:216-205-5668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153022164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse