Basic Information
Provider Information
NPI: 1760751333
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: KATIE
MiddleName: RILEY
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 121 RED BERRY HOLLY LN
Address2:  
City: HURDLE MILLS
State: NC
PostalCode: 275417391
CountryCode: US
TelephoneNumber: 3363641179
FaxNumber:  
Practice Location
Address1: 508 FULTON ST
Address2:  
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/27/2011
LastUpdateDate: 12/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X245834NCN Nursing Service ProvidersRegistered Nurse 
163WG0000X245834NCN Nursing Service ProvidersRegistered NurseGeneral Practice
163WM0705X245834NCY Nursing Service ProvidersRegistered NurseMedical-Surgical

No ID Information.


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