Provider Demographics
NPI:1164022620
Name:FRANKLIN, CASEY NICOLE
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:NICOLE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 N FM 620 RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-1011
Mailing Address - Country:US
Mailing Address - Phone:512-335-5275
Mailing Address - Fax:512-335-6673
Practice Address - Street 1:13201 N FM 620 RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-1011
Practice Address - Country:US
Practice Address - Phone:512-335-5275
Practice Address - Fax:512-335-6673
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist