Provider Demographics
NPI:1902369457
Name:FRANKLIN, REBECCA J (FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 SUNSET DR STE 104
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-4080
Mailing Address - Country:US
Mailing Address - Phone:662-226-0110
Mailing Address - Fax:662-226-3700
Practice Address - Street 1:1117 SUNSET DR STE 104
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4080
Practice Address - Country:US
Practice Address - Phone:662-226-0110
Practice Address - Fax:662-226-3700
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily