| Doctor Name: | EBONI BROWN FREEMAN |
| NPI Number: | 1083939235 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP010648 |
| Business Practice Address: | 455 Pennsylvania Ave Suite 105 Fort Washington, PA - 190343403 |
| Business Phone Number: | 2157934546 |
| Business Fax Number: | 2157939007 |
| Mailing Address: | 455 Pennsylvania Ave, Suite 105 FORT WASHINGTON |
| State: | PA |
| Postal Code: | 190343403 |
| Phone Number: | 2157934546 |
| Fax Number: | 2157939007 |
| NPI Enumeration Date: | 03/31/2010 |
| NPI Last Update Date: | 03/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | SP010648 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |