Provider Demographics
NPI:1043622400
Name:FREEBERG, CASEY RHEA (NP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:RHEA
Last Name:FREEBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:RHEA
Other - Last Name:CRITTENDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5510 WEDDINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-0622
Mailing Address - Country:US
Mailing Address - Phone:770-856-2187
Mailing Address - Fax:
Practice Address - Street 1:5510 WEDDINGTON DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-0622
Practice Address - Country:US
Practice Address - Phone:770-856-2187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218331363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily