Provider Demographics
NPI:1770626731
Name:FRANKE, CHERYLAN J (M ED, CDS)
Entity type:Individual
Prefix:MRS
First Name:CHERYLAN
Middle Name:J
Last Name:FRANKE
Suffix:
Gender:F
Credentials:M ED, CDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 SHIVE LN
Mailing Address - Street 2:# 64
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-8003
Mailing Address - Country:US
Mailing Address - Phone:270-202-3479
Mailing Address - Fax:270-781-9413
Practice Address - Street 1:1013 SHIVE LN
Practice Address - Street 2:# 64
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-8003
Practice Address - Country:US
Practice Address - Phone:270-202-3479
Practice Address - Fax:270-781-9413
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY01999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01999OtherCBIS CABINET OF HEALTH