Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP2285 | AZ |
N | 363LP0200X | Nurse Practitioner - Pediatrics | RN135409 | AZ |
NPI | 1043338544 |
---|---|
Provider Name | Karen Freeman |
First Address | Las Vegas, NV 89144-6649 |
Second Address | Las Vegas, NV 89144-6649 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 07/01/2019 |