NICOLE FREEBORN (NPI# 1043776149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043776149 |
Entity Type | Individual |
Full Name | NICOLE FREEBORN |
Credential | IDC |
Practice Address |
34800 Bob Wilson Dr Fpo AP 92134 |
Mailing Address |
34800 Bob Wilson Dr San Diego CA 92134-1098 |
Practice Telephone | 6195326898 |
Enumeration Date | 2019-02-13 |
Last Update Date | 2019-02-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
Street Address |
34800 BOB WILSON DR |
City | FPO |
State | AP |
Zip Code | 92134 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
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Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
1396370623 | Daniel Rocha Moy | Military Health Care Provider | Uss Thunderbolt (pc-12), Fpo, AE 09588 | 2020-03-06 |
1639701634 | Stephen Henderson | Military Health Care Provider | 3d Recon Bn, Force Co., Unit 36180, Fpo, AP 96389-6180 | 2020-02-07 |
1649810219 | Maxwell Onyedikachi Osisioma | Military Health Care Provider | Psd-18, Macg-18, 1st Maw Unit 37172, Fpo, AP 96372 | 2020-01-13 |
1508406273 | Daniel Levin | Military Health Care Provider | 3d Recon Bn Aid Station, Fpo, AP 96389-6189 | 2020-01-10 |
1053955609 | Christopher Zartman | Military Health Care Provider | Camp Foster, Okinawa Japan, Fpo, AP 96379-0005 | 2019-11-06 |
1912553975 | Brandon Joseph Dapper | Military Health Care Provider | Camp Lejeune, Nc, 2d Reconnaissance Battalion Battalion Aid Station, Fpo, AA 28542-0138 | 2019-08-15 |
1518525583 | William Edward Mcbreen Jr. | Military Health Care Provider | Coastal Riverine Group 1 Detachment Guam, Fpo, AP 96540-1400 | 2019-06-04 |
1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.