Provider Demographics
NPI:1477303659
Name:FRANCISCO, CARMEN LUISA
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:LUISA
Last Name:FRANCISCO
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 1:2606 W QUINCY CIR
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-6229
Mailing Address - Country:US
Mailing Address - Phone:918-600-7034
Mailing Address - Fax:
Practice Address - Street 1:2606 W QUINCY CIR
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6229
Practice Address - Country:US
Practice Address - Phone:918-600-7034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist