OCTAVIA RAQUEL HOLLOWAY-FREEMAN (NPI# 1518590744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518590744 |
| Entity Type | Individual |
| Full Name | OCTAVIA RAQUEL HOLLOWAY-FREEMAN |
| Credential | NP-C |
| Practice Address |
301 Denmark St Statesboro GA 30458-5208 |
| Practice Telephone | 9129963943 |
| Mailing Telephone | 9139963943 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
184049 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
301 DENMARK ST |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306464250 | Leah Reed | Family Medicine | 2082 Cherokee Farms Cv, Buford, GA 30519-7004 | 2020-07-08 |
| 1083240766 | Carehere LLC | Family Medicine | 114 N Jackson St, Albany, GA 31701-2583 | 2020-03-13 |
| 1891331575 | Jenna Barnes | Family Medicine | 1107 Memorial Dr Ste 300, Dalton, GA 30720-8664 | 2019-11-18 |
| 1023651205 | Carehere LLC | Family Medicine | 750 S Perry St Ste 200, Lawrenceville, GA 30046-4804 | 2019-10-21 |
| 1003385733 | James G Hamilton Jr Md LLC | Family Medicine | 4898 Highway 197, Mount Airy, GA 30563-2442 | 2018-11-26 |
| 1780161323 | Personal Wellness Inc. | Family Medicine | 625 Boxwood Ter, Johns Creek, GA 30005-7217 | 2018-07-26 |
| 1073005138 | Lake Oconee Wellness Associates LLC | Family Medicine | 1097 Lake Oconee Pkwy Ste 201, Eatonton, GA 31024-9510 | 2018-06-05 |
| 1376034983 | Lee Pennington Mcnichols | Family Medicine | 2300 Bethelview Rd Ste 110-332, Cumming, GA 30040-9475 | 2018-05-21 |
| 1972021301 | Docpecox, LLC | Family Medicine | 755 Mount Vernon Hwy Ne Ste 350, Atlanta, GA 30328-4291 | 2017-09-06 |
| 1619493939 | Unicare Family Practice | Family Medicine | 4439 Austell Rd, Austell, GA 30106-1839 | 2017-08-17 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
Please comment or provide details below to improve the information on OCTAVIA RAQUEL HOLLOWAY-FREEMAN.
| 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.