Provider Demographics
NPI:1598305906
Name:FREEMAN-HICKS, SHAWLAWN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHAWLAWN
Middle Name:
Last Name:FREEMAN-HICKS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 SANDLER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6368
Mailing Address - Country:US
Mailing Address - Phone:804-944-5057
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTHLAKE BLVD STE J
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3061
Practice Address - Country:US
Practice Address - Phone:804-944-5057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178682363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health