Provider Demographics
NPI:1336991587
Name:FREEMAN, CHIQUITA R
Entity Type:Individual
Prefix:
First Name:CHIQUITA
Middle Name:R
Last Name:FREEMAN
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 1:18937 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-2063
Mailing Address - Country:US
Mailing Address - Phone:313-888-6005
Mailing Address - Fax:
Practice Address - Street 1:18937 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-2063
Practice Address - Country:US
Practice Address - Phone:313-888-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide