| Freedom Healthcare, Llc | |
|
8899 S 700 E Ste 250 Sandy UT 84070 | |
| (801) 613-2711 | |
| Not Available |
| Full Name | Freedom Healthcare, Llc |
|---|---|
| Speciality | General Practice |
| Location | 8899 S 700 E, Sandy, Utah |
| Authorized Official Name and Position | Jeffrey Nelson (OWNER) |
| Authorized Official Contact | 8019460294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Healthcare, Llc 8899 S 700 E Ste 250 Sandy UT 84070-1810 Ph: () - | Freedom Healthcare, Llc 8899 S 700 E Ste 250 Sandy UT 84070 Ph: (801) 613-2711 |
| NPI Number | 1770916306 |
|---|---|
| Provider Enumeration Date | 08/19/2013 |
| Last Update Date | 07/19/2018 |
| Medicare PECOS PAC ID | 7416181953 |
|---|---|
| Medicare Enrollment ID | O20131016000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770916306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 7465201-1204 (Utah) | Primary |
| Provider Name | Jeffrey S Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619961315 PECOS PAC ID: 1355515248 Enrollment ID: I20111110000165 |
| Provider Name | Kenzlee Wooden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043851116 PECOS PAC ID: 2264867795 Enrollment ID: I20200110001166 |
| Provider Name | Jennifer R Landberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922501139 PECOS PAC ID: 4981950631 Enrollment ID: I20200124001611 |
| Provider Name | Jennifer Lynn Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386251742 PECOS PAC ID: 7810317393 Enrollment ID: I20201022000707 |
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