Provider Demographics
NPI:1982428645
Name:FREDA, SARA (RN, FNP STUDENT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FREDA
Suffix:
Gender:F
Credentials:RN, FNP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 USHER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-8009
Mailing Address - Country:US
Mailing Address - Phone:205-446-7321
Mailing Address - Fax:
Practice Address - Street 1:1 HARRISON PLZ
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35632-0002
Practice Address - Country:US
Practice Address - Phone:256-765-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program