Individual ProviderShanna L FreemanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Ucla Medical Plz Ste 526, Los Angeles, CA 90095-8344(310) 267-0182PECOS EnrollmentBased on the most recent information from CMS, provider Shanna L Freeman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1326270877Provider TypeIndividualFull NameFreeman, Shanna LCredentialNURSE PRACTITIONERGenderFemaleSole ProprietorYesEnumeration Date8/18/2009Last Updated12/20/2019Contact InformationPractice LocationPractice Address200 Ucla Medical Plz Ste 526, Los Angeles, CA 90095-8344Phone(310) 267-0182Fax(310) 825-4813Mailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense20639CaliforniaCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense792044CaliforniaProvider IdentifiersIDDescriptionIssuerID1326270877DescriptionOtherIssuerNPI