Provider Demographics
NPI:1497799068
Name:FRANK, VINNETTE (PA)
Entity Type:Individual
Prefix:
First Name:VINNETTE
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:ROWAN
Mailing Address - State:IA
Mailing Address - Zip Code:50470-7515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1316 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2019
Practice Address - Country:US
Practice Address - Phone:515-532-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA33444OtherFPC BCBS NRH
IA36174OtherBCBS DME
IA0424507Medicaid
IA0600460Medicaid
IA0293522Medicaid
IA0655001Medicaid
IA0283465Medicaid
IA29352OtherBCBS ER
IA66046OtherBCBS SNF
IA0635011Medicaid
IA60046OtherBCBS REG
IA163495Medicare ID - Type UnspecifiedFPC MEDICARE
IA33444OtherFPC BCBS NRH
IA0655001Medicaid
IA16Z302Medicare Oscar/Certification
IA29352OtherBCBS ER
IAP31683Medicare UPIN
IA0381980001Medicare NSC
IA66046OtherBCBS SNF