Basic Information
Provider Information
NPI: 1881105823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANCK
FirstName: EMILY
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 950244
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402950244
CountryCode: US
TelephoneNumber: 5029534700
FaxNumber: 5029968309
Practice Location
Address1: 2215 PORTLAND AVE
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402121033
CountryCode: US
TelephoneNumber: 5027748631
FaxNumber: 5029968309
Other Information
ProviderEnumerationDate: 10/17/2017
LastUpdateDate: 04/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3011661KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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