Provider Demographics
NPI:1487740841
Name:FREEMAN, AMY MARIE (RD/N, CDCES)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RD/N, CDCES
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6545 SW 18TH TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0122
Mailing Address - Country:US
Mailing Address - Phone:931-572-8776
Mailing Address - Fax:
Practice Address - Street 1:8375 SW HWY 200
Practice Address - Street 2:DIABETES CENTER
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481
Practice Address - Country:US
Practice Address - Phone:352-401-1338
Practice Address - Fax:352-401-1338
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1712133V00000X
FLND5645133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered