Healthcare Provider Details

I. General information

NPI: 1528144029
Provider Name (Legal Business Name): DANIELLE FRANK OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TATES CREEK CENTRE DR
LEXINGTON KY
40517-3066
US

IV. Provider business mailing address

4101 TATES CREEK CENTRE DR
LEXINGTON KY
40517-3066
US

V. Phone/Fax

Practice location:
  • Phone: 859-245-3332
  • Fax: 859-245-0032
Mailing address:
  • Phone: 859-245-3332
  • Fax: 859-245-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1330DT
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1330DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: