Provider Demographics
NPI:1619128162
Name:FONGKIN, FRANCES ELIZABETH (ARNP)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:ELIZABETH
Last Name:FONGKIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 NE 19TH DRIVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972
Mailing Address - Country:US
Mailing Address - Phone:863-763-6431
Mailing Address - Fax:863-763-2319
Practice Address - Street 1:208 NE 19TH DRIVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972
Practice Address - Country:US
Practice Address - Phone:863-763-6431
Practice Address - Fax:863-763-2319
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1649792363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology