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Individual

GRACEANN A FREEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
620 W 1ST ST, WAPATO, WA 98951-1108
(509) 887-4111
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 579-3298
(702) 667-4689

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61599120
WA
363LF0000X
Family Nurse Practitioner
APN000955
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1124227244
SMA MEDICAID
NV
05
1124227244
NV
01
V110664
SMA MEDICARE
NV
Enumeration date
07/18/2007
Last updated
07/31/2025
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