Provider Demographics
NPI:1104503358
Name:REAL, FRANCINE CHANEL (APRN, PNP-PC)
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:CHANEL
Last Name:REAL
Suffix:
Gender:F
Credentials:APRN, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAHOGANY PATH N
Mailing Address - Street 2:
Mailing Address - City:LA VERNIA
Mailing Address - State:TX
Mailing Address - Zip Code:78121-0080
Mailing Address - Country:US
Mailing Address - Phone:210-410-9059
Mailing Address - Fax:
Practice Address - Street 1:7939 PAT BOOKER RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2753
Practice Address - Country:US
Practice Address - Phone:210-998-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11278436363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics