Healthcare Provider Details

I. General information

NPI: 1497278733
Provider Name (Legal Business Name): MS. HONORA NICOLAI FRANCIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 JEFFERSON AVE
FORT EUSTIS VA
23604
US

IV. Provider business mailing address

576 JEFFERSON AVE
FORT EUSTIS VA
23604-1373
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9000
  • Fax: 702-791-9314
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number340506
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: