Provider Demographics
NPI:1609165620
Name:SMALL - OKHIRIA ABRAHAM, FRANCINE (RN)
Entity Type:Individual
Prefix:MS
First Name:FRANCINE
Middle Name:
Last Name:SMALL - OKHIRIA ABRAHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 HIGHWAY 78 W STE 530-115
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-7915
Mailing Address - Country:US
Mailing Address - Phone:929-200-2887
Mailing Address - Fax:
Practice Address - Street 1:4002 HIGHWAY 78 W STE 530-115
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-7915
Practice Address - Country:US
Practice Address - Phone:929-200-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY609377163W00000X
NY283512164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse