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General NPI Number Information
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NPI Number | 1114206042
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Entity Type | Individual
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Provider Name | CONNIE BEIRO FREEMAN NNP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1000 E MOUNTAIN BLVD
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City | WILKES BARRE
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State | PA
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Zip | 18711-0027
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Country | US
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Telephone | 570-808-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 101-0134470
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 2671445
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | SP012272
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 137875
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 5012691
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | CNP01795
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License Number State | NM
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