Provider Demographics
NPI:1588783682
Name:FREEBORNE-BRINTON, NANCY (PA)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:FREEBORNE-BRINTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 FEATURE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2861
Mailing Address - Country:US
Mailing Address - Phone:703-978-8391
Mailing Address - Fax:
Practice Address - Street 1:2141 K ST NW
Practice Address - Street 2:SUITE 501
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-994-6827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000090363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical