Provider Demographics
NPI:1003308347
Name:FRANKLIN, ELIZABETH ANN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:1114 STAGHORNE WAY
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61705-7509
Mailing Address - Country:US
Mailing Address - Phone:217-791-4776
Mailing Address - Fax:
Practice Address - Street 1:841 BROADMEADOW RD
Practice Address - Street 2:
Practice Address - City:RANTOUL
Practice Address - State:IL
Practice Address - Zip Code:61866-2166
Practice Address - Country:US
Practice Address - Phone:217-282-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-02
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041354591163WE0003X
IL209017960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
F05180615OtherAANP CERTIFICATION NUMBER