Provider Demographics
NPI:1356860084
Name:EMMANUEL-FRANK, SOOKY (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:SOOKY
Middle Name:
Last Name:EMMANUEL-FRANK
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 INDIAN RUN RD
Mailing Address - Street 2:
Mailing Address - City:AMISSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20106-1786
Mailing Address - Country:US
Mailing Address - Phone:571-289-7599
Mailing Address - Fax:
Practice Address - Street 1:2565 COWAN BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8440
Practice Address - Country:US
Practice Address - Phone:540-289-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1248189163W00000X
VA24175384363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse