Provider Demographics
NPI:1093076762
Name:FRANK, DEBRA LYNN (RN, CWON)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:FRANK
Suffix:
Gender:F
Credentials:RN, CWON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3252
Mailing Address - Country:US
Mailing Address - Phone:414-382-5365
Mailing Address - Fax:
Practice Address - Street 1:6614 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-3252
Practice Address - Country:US
Practice Address - Phone:414-382-5365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63149-30163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI63149-30OtherRN LICENSE