Basic Information
Provider Information
NPI: 1225458987
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKLIN
FirstName: KARLISA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 965 RIDGE LAKE BLVD STE 103
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381209446
CountryCode: US
TelephoneNumber:  
FaxNumber: 9012278591
Practice Location
Address1: 1520 UNION AVE
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381043700
CountryCode: US
TelephoneNumber: 9012762410
FaxNumber: 9012616010
Other Information
ProviderEnumerationDate: 04/21/2014
LastUpdateDate: 04/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X18675TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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