Healthcare Provider Details

I. General information

NPI: 1619844313
Provider Name (Legal Business Name): EMMA LEE PATRICIA DEFREITAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6134 SPRINGWATER PL APT B
FREDERICK MD
21701-7304
US

IV. Provider business mailing address

48 FARADAY DR
LUTHERVILLE TIMONIUM MD
21093-2942
US

V. Phone/Fax

Practice location:
  • Phone: 301-865-2216
  • Fax:
Mailing address:
  • Phone: 240-405-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR243402
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: