Provider Demographics
NPI:1760751333
Name:FRANK, KATIE RILEY (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:RILEY
Last Name:FRANK
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 1:121 RED BERRY HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:HURDLE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27541-7391
Mailing Address - Country:US
Mailing Address - Phone:336-364-1179
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC245834163W00000X, 163WG0000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice