Provider Demographics
NPI:1447965827
Name:FREEBORN, ALASONDRA DIANA (PA-C)
Entity type:Individual
Prefix:
First Name:ALASONDRA
Middle Name:DIANA
Last Name:FREEBORN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4836
Mailing Address - Country:US
Mailing Address - Phone:931-484-7596
Mailing Address - Fax:
Practice Address - Street 1:33 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4836
Practice Address - Country:US
Practice Address - Phone:931-484-7596
Practice Address - Fax:931-484-7597
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant