Provider Demographics
NPI:1477536639
Name:FRANKLIN, TRACY LYNETTE (CST/CFA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNETTE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNETTE
Other - Last Name:KIPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CST/CFA
Mailing Address - Street 1:555 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4724
Mailing Address - Country:US
Mailing Address - Phone:775-786-3040
Mailing Address - Fax:775-786-1358
Practice Address - Street 1:555 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4724
Practice Address - Country:US
Practice Address - Phone:775-786-3040
Practice Address - Fax:775-786-1358
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV83618246ZS0410X
NV064324246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV83618OtherLCCST
NV064324OtherNATL CERT AS SURG TECH