Provider Demographics
NPI:1881112613
Name:FREEMAN, PAIGE M (PA-C)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:M
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2042 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:SLAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:56172-1017
Mailing Address - Country:US
Mailing Address - Phone:507-836-6153
Mailing Address - Fax:
Practice Address - Street 1:2042 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:SLAYTON
Practice Address - State:MN
Practice Address - Zip Code:56172-1017
Practice Address - Country:US
Practice Address - Phone:507-836-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant