Healthcare Provider Details

I. General information

NPI: 1275714792
Provider Name (Legal Business Name): CAROL A FRANK MA, LPC, RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6727 ACADEMY RD NE SUITE B
ALBUQUERQUE NM
87109-3391
US

IV. Provider business mailing address

6727 ACADEMY RD NE SUITE B
ALBUQUERQUE NM
87109-3391
US

V. Phone/Fax

Practice location:
  • Phone: 505-821-6056
  • Fax:
Mailing address:
  • Phone: 505-821-6056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0102631
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: