Provider Demographics
NPI:1265473482
Name:FREITAG, PATRICIA KAY (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KAY
Last Name:FREITAG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 180TH ST
Mailing Address - Street 2:
Mailing Address - City:WOLVERTON
Mailing Address - State:MN
Mailing Address - Zip Code:56594-9594
Mailing Address - Country:US
Mailing Address - Phone:218-557-8868
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-239-3700
Practice Address - Fax:701-451-7819
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR100081-8364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist