Provider Demographics
NPI:1467676858
Name:FRANKS, JAN MARIE (CEDAC PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:JAN
Middle Name:MARIE
Last Name:FRANKS
Suffix:
Gender:F
Credentials:CEDAC PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-1121
Mailing Address - Country:US
Mailing Address - Phone:319-283-1646
Mailing Address - Fax:
Practice Address - Street 1:418 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-1121
Practice Address - Country:US
Practice Address - Phone:319-283-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04969193747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider