Healthcare Provider Details

I. General information

NPI: 1225915515
Provider Name (Legal Business Name): LAUREN KELLY FREEBERY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33672 BAYVIEW MEDICAL DR
LEWES DE
19958-1687
US

IV. Provider business mailing address

1515 SAVANNAH RD FL 2
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-703-3630
  • Fax: 302-645-8473
Mailing address:
  • Phone: 302-645-3499
  • Fax: 302-644-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC5-0012317
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012317
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: