Provider Demographics
NPI:1639949324
Name:FREEMAN, HAILEY JO (FNP-C)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:JO
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W6717 US HIGHWAY 10 114
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-9421
Mailing Address - Country:US
Mailing Address - Phone:310-663-6458
Mailing Address - Fax:
Practice Address - Street 1:333 N COMMERCIAL ST STE 100
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2675
Practice Address - Country:US
Practice Address - Phone:920-722-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14743-332085R0204X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily