Provider Demographics
NPI:1750616033
Name:FREEMAN, AMY DIANE (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DIANE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021 CHURCH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2087
Mailing Address - Country:US
Mailing Address - Phone:615-324-1600
Mailing Address - Fax:615-284-2003
Practice Address - Street 1:2400 PATTERSON ST
Practice Address - Street 2:SUITE 319
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1562
Practice Address - Country:US
Practice Address - Phone:615-986-1256
Practice Address - Fax:615-383-0853
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN1751363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1516056Medicaid
TN103I974125Medicare PIN