Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 101-0134470 | VT |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 137875 | AK |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5012691 | NC |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP012272 | PA |
NPI | 1114206042 |
---|---|
Provider Name | Mrs. Connie Beiro Freeman |
First Address | Allentown, PA 18103-5622 |
Second Address | Allentown, PA 18103-6202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2011 |
Last Update Date | 08/09/2021 |