Individual
REBECCA ROSE FREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2697
WI
363AM0700X
Medical Physician Assistant
Primary
2697
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012993
—
WI
01
—
2697
STATE OF WISCONSIN
WI
Enumeration date
11/24/2010
Last updated
06/25/2026
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