Provider Demographics
NPI:1114652658
Name:FRANTZ, CORA (FNP-C, DNP)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:FNP-C, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 HAYS ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-2102
Mailing Address - Country:US
Mailing Address - Phone:661-220-0630
Mailing Address - Fax:
Practice Address - Street 1:330 S CHILOQUIN BLVD
Practice Address - Street 2:
Practice Address - City:CHILOQUIN
Practice Address - State:OR
Practice Address - Zip Code:97624-6747
Practice Address - Country:US
Practice Address - Phone:541-882-1487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202210372NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily