Provider Demographics
NPI:1700692472
Name:FREEMAN, SUSAN L (DNP)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8064 STAR SAPPHIRE CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2261
Mailing Address - Country:US
Mailing Address - Phone:773-600-4422
Mailing Address - Fax:
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 201A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3456
Practice Address - Country:US
Practice Address - Phone:561-488-3128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily