Provider Demographics
NPI:1033143169
Name:FREIBERGER, MICHELLE (ARNP,BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:FREIBERGER
Suffix:
Gender:F
Credentials:ARNP,BC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:IWANICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:820 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2028
Practice Address - Country:US
Practice Address - Phone:509-663-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60565554363LF0000X
IN71001315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200372900Medicaid
IN192290Medicare ID - Type Unspecified
IN200372900Medicaid