Individual
MEGAN FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
9811 W CHARLESTON BLVD, 2-641, LAS VEGAS, NV 89117-7528
(855) 864-4322
Mailing address
902 ASHLEY DR, KALISPELL, MT 59901-5526
(715) 905-1299
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
2956 CNIM
—
2472E0500X
EEG Technician
2956 CNIM
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912171760
GROUP NPI
NV
Enumeration date
07/23/2012
Last updated
05/14/2015
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