Provider Demographics
NPI:1619740594
Name:FREELAND, LORI HAYES (FNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:HAYES
Last Name:FREELAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 MALLARD TRACE DR
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-4417
Mailing Address - Country:US
Mailing Address - Phone:919-740-6156
Mailing Address - Fax:
Practice Address - Street 1:4414 LAKE BOONE TRL STE 405
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7520
Practice Address - Country:US
Practice Address - Phone:919-876-8225
Practice Address - Fax:919-876-3371
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily