Provider Demographics
NPI:1023278363
Name:FRANZEN, JODIE (CNS)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:FRANZEN
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 NE QUAIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-2336
Mailing Address - Country:US
Mailing Address - Phone:580-353-2268
Mailing Address - Fax:
Practice Address - Street 1:1407 N WHISENANT DR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1650
Practice Address - Country:US
Practice Address - Phone:580-251-8242
Practice Address - Fax:580-251-8892
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0073388364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal