Provider Demographics
NPI:1285954073
Name:FREEMAN GIL, JOANNE ELIZABETH (NP-BC)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:ELIZABETH
Last Name:FREEMAN GIL
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2816
Mailing Address - Country:US
Mailing Address - Phone:323-270-9390
Mailing Address - Fax:
Practice Address - Street 1:240 N VIRGIL AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-5399
Practice Address - Country:US
Practice Address - Phone:323-270-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner