Individual
MRS. SHAUNDA T FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2045 HWY 61 NORTH, PORT GIBSON, MS 39150-4262
(601) 437-3050
(601) 437-3051
Mailing address
PO BOX 741, PORT GIBSON, MS 39150-0741
(601) 437-3050
(601) 437-3051
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R864672
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02975221
—
MS
Enumeration date
11/02/2006
Last updated
04/20/2011
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