Healthcare Provider Details

I. General information

NPI: 1255382685
Provider Name (Legal Business Name): ANGELA L BAKER-FRANCKOWIAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 W RAWSON AVE
FRANKLIN WI
53132-8104
US

IV. Provider business mailing address

7322 W RAWSON AVE
FRANKLIN WI
53132-8104
US

V. Phone/Fax

Practice location:
  • Phone: 414-228-4800
  • Fax: 414-433-9007
Mailing address:
  • Phone: 414-228-4800
  • Fax: 414-433-9007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number45580
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number45580-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: