Provider Demographics
NPI:1083622815
Name:FREEMAN, PATRICIA YVONNE (CANP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:YVONNE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CANP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:YVONNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CANP
Mailing Address - Street 1:1800 ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0010
Mailing Address - Country:US
Mailing Address - Phone:410-502-0856
Mailing Address - Fax:410-955-1884
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-502-0856
Practice Address - Fax:410-955-1884
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR104150363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health