Healthcare Provider Details

I. General information

NPI: 1447690300
Provider Name (Legal Business Name): SHYLOE FRANZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N US HIGHWAY 89
PRESCOTT AZ
86313-5001
US

IV. Provider business mailing address

2365 W BARD RANCH RD
PRESCOTT AZ
86305-7769
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-4860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS013649
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: