Individual
MICAYLA KATHLEEN FREEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1009 DAWSON ST, WACO, TX 76704-1913
(508) 523-7695
Mailing address
1009 DAWSON ST, WACO, TX 76704-1913
(508) 523-7695
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1026164
TX
163W00000X
Registered Nurse
95221700
CA
163WP0200X
Pediatric Registered Nurse
1026164
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
1026164
TX
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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