Provider Demographics
NPI:1306306931
Name:FREEMAN, TRACEY SCOTT (RN)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:SCOTT
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5152 E. SILVER SAGE LANE
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3316
Mailing Address - Country:US
Mailing Address - Phone:480-395-4484
Mailing Address - Fax:623-321-8797
Practice Address - Street 1:5152 E. SILVER SAGE LANE
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3316
Practice Address - Country:US
Practice Address - Phone:480-395-4484
Practice Address - Fax:623-321-8797
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances