Healthcare Provider Details

I. General information

NPI: 1760651145
Provider Name (Legal Business Name): DEBORAH A FREEMAN RN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WESTERN AVE STE A
KENNEBUNK ME
04043-7354
US

IV. Provider business mailing address

PO BOX 648
KENNEBUNKPORT ME
04046
US

V. Phone/Fax

Practice location:
  • Phone: 833-952-0829
  • Fax:
Mailing address:
  • Phone: 207-284-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP81325
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: