Provider Demographics
NPI:1316960644
Name:FRESHMAN, MICHELLE (MPH MSN APRN BC MSCN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:FRESHMAN
Suffix:
Gender:F
Credentials:MPH MSN APRN BC MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:NEWTON WELLESLEY HOSPITAL
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-243-5480
Mailing Address - Fax:617-243-6701
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:NEWTON WELLESLEY HOSPITAL
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-243-5480
Practice Address - Fax:617-243-6701
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP4245OtherBCBS
NP4245OtherBCBS
MANP424501Medicare PIN