Healthcare Provider Details

I. General information

NPI: 1659196947
Provider Name (Legal Business Name): FREEDOM PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 SHUNPIKE RD
CROMWELL CT
06416-2442
US

IV. Provider business mailing address

26 SHUNPIKE RD
CROMWELL CT
06416-2442
US

V. Phone/Fax

Practice location:
  • Phone: 860-245-1791
  • Fax: 860-969-2791
Mailing address:
  • Phone: 860-245-1791
  • Fax: 860-969-2791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: YVONNE L JOY
Title or Position: OWNER, CEO, NP
Credential: APRN
Phone: 860-539-5262