Healthcare Provider Details

I. General information

NPI: 1316649759
Provider Name (Legal Business Name): ELMA FRANCEWARE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US HWY 64, OLD HIGH SCHOOL RD.
SHIPROCK NM
87420
US

IV. Provider business mailing address

PO BOX 1199
SHIPROCK NM
87420-1199
US

V. Phone/Fax

Practice location:
  • Phone: 505-368-5123
  • Fax:
Mailing address:
  • Phone: 505-368-5163
  • Fax: 505-368-5502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number417086
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number417086
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: