Provider Demographics
NPI:1043899776
Name:FRANCK, LORI A (APNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:FRANCK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5662
Mailing Address - Country:US
Mailing Address - Phone:920-205-8270
Mailing Address - Fax:
Practice Address - Street 1:100 THEDA CLARK MEDICAL PLZ STE 400
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2763
Practice Address - Country:US
Practice Address - Phone:920-725-4527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10876-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty