Provider Demographics
NPI:1649094004
Name:FREEMAN, JOYCE C
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:C
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 1:4325 9TH AVENUE CIR S APT 32
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-7060
Mailing Address - Country:US
Mailing Address - Phone:701-212-2281
Mailing Address - Fax:
Practice Address - Street 1:4325 9TH AVENUE CIR S APT 32
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7060
Practice Address - Country:US
Practice Address - Phone:701-212-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND591063747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant