Provider Demographics
NPI:1669005393
Name:FRANKLIN, RUSSELL (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 DAVIS RD SW
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRING
Mailing Address - State:GA
Mailing Address - Zip Code:30124-2435
Mailing Address - Country:US
Mailing Address - Phone:706-767-3318
Mailing Address - Fax:
Practice Address - Street 1:1775 DAVIS RD SW
Practice Address - Street 2:
Practice Address - City:CAVE SPRING
Practice Address - State:GA
Practice Address - Zip Code:30124-2435
Practice Address - Country:US
Practice Address - Phone:706-767-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily