Healthcare Provider Details

I. General information

NPI: 1427095405
Provider Name (Legal Business Name): THOMAS FREICHELS, CS, APNP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14854 W MAYFLOWER CT
NEW BERLIN WI
53151-6747
US

IV. Provider business mailing address

14854 W MAYFLOWER CT
NEW BERLIN WI
53151-6747
US

V. Phone/Fax

Practice location:
  • Phone: 262-782-7911
  • Fax:
Mailing address:
  • Phone: 262-782-7911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: THOMAS FREICHELS
Title or Position: PRESIDENT
Credential: APNP
Phone: 262-782-7911