Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | IP 1030 | KY |
N | 207V00000X | Obstetrician & Gynecologist | LL29242 | SC |
Y | 207V00000X | Obstetrician & Gynecologist | TP835 | KY |
N | 207VX0000X | Obstetrician | 45961 | TN |
NPI | 1427132489 |
---|---|
Provider Name | Stephanie Anne Freeman |
First Address | Bowling Green, KY 42101-1759 |
Second Address | Glasgow, KY 42141-3486 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 25/01/2016 |