Provider Demographics
NPI:1215401393
Name:RENE, FRANCKLINE (RN, MSN)
Entity Type:Individual
Prefix:
First Name:FRANCKLINE
Middle Name:
Last Name:RENE
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 SW 126TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3844
Mailing Address - Country:US
Mailing Address - Phone:954-864-7735
Mailing Address - Fax:
Practice Address - Street 1:2789 SW 126TH WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3844
Practice Address - Country:US
Practice Address - Phone:954-864-7735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2018076881363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2018076681OtherFAMILY NURSE PRACTITIONER
FL9166575OtherREGISTERED NURSE