Provider Demographics
NPI:1548615289
Name:FRANCIS, CONRAD
Entity Type:Individual
Prefix:
First Name:CONRAD
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 ERIC CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2736
Mailing Address - Country:US
Mailing Address - Phone:757-535-2238
Mailing Address - Fax:
Practice Address - Street 1:7235 BONNEVAL RD
Practice Address - Street 2:SUITE# 812
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7565
Practice Address - Country:US
Practice Address - Phone:678-849-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator