Healthcare Provider Details

I. General information

NPI: 1891690905
Provider Name (Legal Business Name): MARY ELLEN FRANKLIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LEGION AVE
CALHOUN CITY MS
38916-6601
US

IV. Provider business mailing address

105 LEGION AVE
CALHOUN CITY MS
38916-6601
US

V. Phone/Fax

Practice location:
  • Phone: 662-628-8267
  • Fax: 662-628-8266
Mailing address:
  • Phone: 662-628-8267
  • Fax: 662-628-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908865
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: