Provider Demographics
NPI:1174991434
Name:FREWIN, COLLEEN R (CRNP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:R
Last Name:FREWIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:R
Other - Last Name:HASSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 W MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAXONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16056-2254
Mailing Address - Country:US
Mailing Address - Phone:724-352-8422
Mailing Address - Fax:724-352-8426
Practice Address - Street 1:333 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:SAXONBURG
Practice Address - State:PA
Practice Address - Zip Code:16056-2254
Practice Address - Country:US
Practice Address - Phone:724-352-8422
Practice Address - Fax:724-352-8426
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13945564OtherCAQH
PA103233519-Medicaid
PA556457Medicare PIN