Provider Demographics
NPI:1457625089
Name:FRENCH, ALAN THANE (BSN)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:THANE
Last Name:FRENCH
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NW NAVAJO RT 12 & N7
Mailing Address - Street 2:PO BOX 649
Mailing Address - City:FT. DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504
Mailing Address - Country:US
Mailing Address - Phone:720-810-9996
Mailing Address - Fax:928-729-8499
Practice Address - Street 1:NW NAVAJO RT 12 & N7
Practice Address - Street 2:
Practice Address - City:FT. DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504-0649
Practice Address - Country:US
Practice Address - Phone:720-810-9996
Practice Address - Fax:928-729-8499
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-167475-2171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator