Provider Demographics
NPI:1821112533
Name:ETZOLD, FRANCES PAULINA (RN)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:PAULINA
Last Name:ETZOLD
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 1:202 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-9004
Mailing Address - Country:US
Mailing Address - Phone:828-675-9048
Mailing Address - Fax:828-682-6262
Practice Address - Street 1:202 MEDICAL CAMPUS DR
Practice Address - Street 2:YANCEY COUNTY HEALTH DEPT
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-9004
Practice Address - Country:US
Practice Address - Phone:828-682-6118
Practice Address - Fax:828-682-6262
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC115244163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC115244OtherSTATE LICENSE