Provider Demographics
NPI:1144899683
Name:FREEMAN, PAMELA CHARMAINE (HIM , CIC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:CHARMAINE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:HIM , CIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W BROWN DEER RD # 491
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2372
Mailing Address - Country:US
Mailing Address - Phone:262-358-6163
Mailing Address - Fax:262-358-6163
Practice Address - Street 1:333 W BROWN DEER RD # 491
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-2372
Practice Address - Country:US
Practice Address - Phone:262-358-6163
Practice Address - Fax:262-358-6163
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program