Provider Demographics
NPI:1750999439
Name:BEAUBRUN, FRANCKY L (CSA,MD)
Entity type:Individual
Prefix:
First Name:FRANCKY
Middle Name:L
Last Name:BEAUBRUN
Suffix:
Gender:M
Credentials:CSA,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-1853
Mailing Address - Country:US
Mailing Address - Phone:708-632-8145
Mailing Address - Fax:
Practice Address - Street 1:17 GLEN CT
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-1853
Practice Address - Country:US
Practice Address - Phone:978-476-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program