FREEDOM LOUNGE PLLC NPI 1275154585

NPI Information

NPI: 1275154585
Provider Name: FREEDOM LOUNGE PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
209 E BASELINE RD STE E107
TEMPE, AZ
ZIP 85283
Phone: (480) 531-5973
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FREEDOM LOUNGE PLLC is a psychiatric/mental health nurse practitioner in Tempe, AZ. FREEDOM LOUNGE PLLC NPI is 1275154585. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

209 E BASELINE RD STE E107
TEMPE, AZ
ZIP 85283-299
Phone: (480) 531-5973
Fax: (480) 542-8173

The provider's authorized official is George Michael Wickham .
The authorized official title is General Partner and has the following contact phone number (480) 531-5973.

The enumeration date for this NPI number is 4/28/2020 and was last updated on 4/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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