Healthcare Provider Details

I. General information

NPI: 1174576227
Provider Name (Legal Business Name): VIRGINIA G FRANKS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CIRCLE CREEK WAY
ORMOND BEACH FL
32174-1823
US

IV. Provider business mailing address

2 CIRCLE CREEK WAY
ORMOND BEACH FL
32174-1823
US

V. Phone/Fax

Practice location:
  • Phone: 913-961-0415
  • Fax:
Mailing address:
  • Phone: 913-961-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28181596A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2001000464
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-55513-111
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1385665111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: