Provider Demographics
NPI:1871201939
Name:FREEMAN, COLLEEN A (RN)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BOYD KENNEDY RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-9728
Mailing Address - Country:US
Mailing Address - Phone:775-388-3458
Mailing Address - Fax:
Practice Address - Street 1:352 BOYD KENNEDY RD
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815
Practice Address - Country:US
Practice Address - Phone:775-388-3458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN48774163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy