Healthcare Provider Details

I. General information

NPI: 1851762587
Provider Name (Legal Business Name): JULIE FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 MAIN ST
GORHAM ME
04038-2623
US

IV. Provider business mailing address

PO BOX 6149
ALOHA OR
97007-0149
US

V. Phone/Fax

Practice location:
  • Phone: 207-839-2559
  • Fax: 207-523-1135
Mailing address:
  • Phone: 503-352-8657
  • Fax: 503-352-8658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201506046NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP151064
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: