Provider Demographics
NPI:1033914296
Name:FREEMAN, SHAUNA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HALO AVE
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2112
Mailing Address - Country:US
Mailing Address - Phone:856-885-3593
Mailing Address - Fax:
Practice Address - Street 1:1233 HADDONFIELD BERLIN RD STE 4
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4378
Practice Address - Country:US
Practice Address - Phone:800-943-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15246400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health