Provider Demographics
NPI:1710489471
Name:JEAN-FANCOIS, KARTHIANA (LPN)
Entity Type:Individual
Prefix:
First Name:KARTHIANA
Middle Name:
Last Name:JEAN-FANCOIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 AUDUBON RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1230
Mailing Address - Country:US
Mailing Address - Phone:978-335-7805
Mailing Address - Fax:
Practice Address - Street 1:255 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-3508
Practice Address - Country:US
Practice Address - Phone:617-884-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN96030164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse