Doctor Name: | LACEY FREEMAN |
NPI Number: | 1679998785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.R.N. |
License Number: | A004027 |
Business Practice Address: | 9755 W State Highway 22 Ratcliff, AR - 729519000 |
Business Phone Number: | 4796350091 |
Business Fax Number: | 4796355302 |
Mailing Address: | Po Box 130, RATCLIFF |
State: | AR |
Postal Code: | 729510130 |
Phone Number: | 4796350091 |
Fax Number: | 4796355302 |
NPI Enumeration Date: | 02/26/2014 |
NPI Last Update Date: | 02/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |