Provider Demographics
NPI:1740535467
Name:FREER, STEPHANIE LYNN (LPN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:FREER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 COUNTY RT 36
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13780
Mailing Address - Country:US
Mailing Address - Phone:607-336-7615
Mailing Address - Fax:
Practice Address - Street 1:712 COUNTY RT 36
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:NY
Practice Address - Zip Code:13780
Practice Address - Country:US
Practice Address - Phone:607-336-7615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291144-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse