Healthcare Provider Details

I. General information

NPI: 1568978435
Provider Name (Legal Business Name): DEEDRA DOWDEN FRANKE RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 12/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10807 FALLS RD STE 200
LUTHERVILLE MD
21093-4595
US

IV. Provider business mailing address

511 MURDOCK RD
BALTIMORE MD
21212-2021
US

V. Phone/Fax

Practice location:
  • Phone: 410-321-9393
  • Fax:
Mailing address:
  • Phone: 410-371-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRO76666
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: