Provider Demographics
NPI:1982707873
Name:FREEMAN, SUZANNE (APRN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:ROLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN FNP
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-293-7330
Practice Address - Street 1:1 RICHLAND MEDICAL PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6831
Practice Address - Country:US
Practice Address - Phone:803-545-5350
Practice Address - Fax:803-545-5353
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0514Medicaid
P354052603Medicare ID - Type Unspecified
SCNP0514Medicaid
SCP354052603Medicare PIN