Healthcare Provider Details

I. General information

NPI: 1174991434
Provider Name (Legal Business Name): COLLEEN R FREWIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN R HASSELL

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W MAIN ST STE 101
SAXONBURG PA
16056-2254
US

IV. Provider business mailing address

333 W MAIN ST STE 101
SAXONBURG PA
16056-2254
US

V. Phone/Fax

Practice location:
  • Phone: 724-352-8422
  • Fax: 724-352-8426
Mailing address:
  • Phone: 724-352-8422
  • Fax: 724-352-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016827
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: