Provider Demographics
NPI:1699080424
Name:FREEMAN, AMY RENE (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:RENE
Other - Last Name:PRIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:717 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1430
Mailing Address - Country:US
Mailing Address - Phone:252-482-0194
Mailing Address - Fax:252-482-0211
Practice Address - Street 1:717 N BROAD ST
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1430
Practice Address - Country:US
Practice Address - Phone:252-482-0194
Practice Address - Fax:252-482-0211
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44281183500000X
NC23566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist