Provider Demographics
NPI:1265642839
Name:FRANKLIN, JEAN
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
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 1:315 BOYDEN RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341-9717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 BOYDEN RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:MA
Practice Address - Zip Code:01341-9717
Practice Address - Country:US
Practice Address - Phone:413-369-4409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32497174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist