Provider Demographics
NPI:1215392469
Name:FRANKS, CHACE
Entity Type:Individual
Prefix:
First Name:CHACE
Middle Name:
Last Name:FRANKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 REGENT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6229
Mailing Address - Country:US
Mailing Address - Phone:731-607-7539
Mailing Address - Fax:
Practice Address - Street 1:1200 BRECKENRIDGE ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1091
Practice Address - Country:US
Practice Address - Phone:270-685-8224
Practice Address - Fax:270-685-8228
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009832363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology