Provider Demographics
NPI:1144229964
Name:FRANZEN, RITA ANN (ANP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:ANN
Last Name:FRANZEN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 CALUMET AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2545
Mailing Address - Country:US
Mailing Address - Phone:219-836-7246
Mailing Address - Fax:219-836-6454
Practice Address - Street 1:8840 CALUMET AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2529
Practice Address - Country:US
Practice Address - Phone:219-836-7246
Practice Address - Fax:219-836-6454
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001050A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00037055OtherMEDICARE RAILROAD
IL90001076OtherBLUE CROSS BLUE SHIELD ILLINOIS
IL71001050AOtherBLUE CROSS BLUE SHIELD IL
IN000000330859OtherBLUE CROSS BLUE SHIELD
IN000000391695OtherBCBS
IN71001050AOtherLICENSE NUMBER
IL90001240OtherBCBS IL
IN200393000AMedicaid
GAP00278645OtherMEDICARE RAILROAD
IL90001076OtherBLUE CROSS BLUE SHIELD ILLINOIS
IN409950FMedicare ID - Type Unspecified
IN200393000AMedicaid