Healthcare Provider Details

I. General information

NPI: 1982513859
Provider Name (Legal Business Name): MARANDY RENEE FRANKLIN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25701 HIGHWAY 107
JACKSONVILLE AR
72076-2238
US

IV. Provider business mailing address

11209 JACKSONVILLE CATO RD
SHERWOOD AR
72120-1840
US

V. Phone/Fax

Practice location:
  • Phone: 501-988-4131
  • Fax:
Mailing address:
  • Phone: 501-992-6839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL041046
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: