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Individual

MR. CHADRICK KORTEZ FREEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
4284 LOMAC ST, MONTGOMERY, AL 36106
(334) 272-6062
Mailing address
4284 LOMAC ST, MONTGOMERY, AL 36106-3604
(334) 272-6062
(334) 272-6019

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-104187
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198240
AL
01
511-89954
BLUECROSS BLUESHIELD OF ALABAMA
AL
Enumeration date
11/13/2016
Last updated
06/15/2018
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