Provider Demographics
NPI:1760984496
Name:BYRNSIDE, FRANCES (PCA)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:
Last Name:BYRNSIDE
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:WV
Mailing Address - Zip Code:25011
Mailing Address - Country:US
Mailing Address - Phone:304-552-5678
Mailing Address - Fax:
Practice Address - Street 1:119 2ND AVE
Practice Address - Street 2:
Practice Address - City:BANCROFT
Practice Address - State:WV
Practice Address - Zip Code:25011
Practice Address - Country:US
Practice Address - Phone:304-552-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
G20032305006OtherPROVIDER ID