Provider Demographics
NPI:1841353208
Name:FREEMAN, SUE (NP)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1144 65TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1053
Mailing Address - Country:US
Mailing Address - Phone:510-929-1400
Mailing Address - Fax:510-929-1414
Practice Address - Street 1:19303 N NEW TRADITION RD
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-3806
Practice Address - Country:US
Practice Address - Phone:623-624-8280
Practice Address - Fax:602-835-0192
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN-092188363LG0600X
AZAP6923363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology