Provider Demographics
NPI:1831442011
Name:FREEMAN, CASEY LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:LYNN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:LYNN
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 PENN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1956
Mailing Address - Country:US
Mailing Address - Phone:717-632-4449
Mailing Address - Fax:717-632-3553
Practice Address - Street 1:111 PENN ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1959
Practice Address - Country:US
Practice Address - Phone:717-632-4449
Practice Address - Fax:717-633-3553
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012458363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health