Provider Demographics
NPI:1477845527
Name:FRANKLIN, MECHELLE TANISHIA
Entity Type:Individual
Prefix:
First Name:MECHELLE
Middle Name:TANISHIA
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 1:2303 TARLETON LN
Mailing Address - Street 2:APT C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2252
Mailing Address - Country:US
Mailing Address - Phone:410-963-0503
Mailing Address - Fax:
Practice Address - Street 1:2303 TARLETON LN
Practice Address - Street 2:APT C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2252
Practice Address - Country:US
Practice Address - Phone:410-963-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse