Healthcare Provider Details

I. General information

NPI: 1720180979
Provider Name (Legal Business Name): JOY Y FRANKS CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOY Y LODEN

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 IVIE LN
MANTACHIE MS
38855-9764
US

IV. Provider business mailing address

470 NICHOLS RD NW
MANTACHIE MS
38855-9200
US

V. Phone/Fax

Practice location:
  • Phone: 662-282-4197
  • Fax: 662-282-5121
Mailing address:
  • Phone: 662-871-5127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR857240
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: