Individual
PATRICIA FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3301 N BALLARD RD, APPLETON, WI 54911-8928
(920) 753-8816
Mailing address
PO BOX 112, KIMBERLY, WI 54136-0112
(920) 734-7178
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
179696-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467503193
—
WI
Enumeration date
06/13/2018
Last updated
06/13/2018
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