Provider Demographics
NPI:1912070921
Name:FRANZ, JOAN BETH
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:BETH
Last Name:FRANZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-6014
Mailing Address - Country:US
Mailing Address - Phone:907-455-6380
Mailing Address - Fax:907-455-7391
Practice Address - Street 1:1569 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-6014
Practice Address - Country:US
Practice Address - Phone:907-455-6380
Practice Address - Fax:907-455-7391
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK438225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOT9778Medicaid