Healthcare Provider Details

I. General information

NPI: 1598827065
Provider Name (Legal Business Name): PATRICIA ANN FRESHMAN CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 1ST ST STE. P302
DULUTH MN
55805-2201
US

IV. Provider business mailing address

920 E 1ST ST STE. P302
DULUTH MN
55805-2201
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-6050
  • Fax: 218-249-6055
Mailing address:
  • Phone: 218-249-6050
  • Fax: 218-249-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR1581832
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: