Provider Demographics
NPI:1881814861
Name:FREEBURG, BARBARA GRACE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:GRACE
Last Name:FREEBURG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:GRACE
Other - Last Name:IVERSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2294 US HWY 59
Mailing Address - Street 2:
Mailing Address - City:GARVIN
Mailing Address - State:MN
Mailing Address - Zip Code:56132
Mailing Address - Country:US
Mailing Address - Phone:507-763-3521
Mailing Address - Fax:
Practice Address - Street 1:106 NORTH 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1034
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL0496481164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse