Healthcare Provider Details

I. General information

NPI: 1093076762
Provider Name (Legal Business Name): DEBRA LYNN FRANK RN, CWON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6614 CEDAR ST
WAUWATOSA WI
53213-3252
US

IV. Provider business mailing address

6614 CEDAR ST
WAUWATOSA WI
53213-3252
US

V. Phone/Fax

Practice location:
  • Phone: 414-382-5365
  • Fax:
Mailing address:
  • Phone: 414-382-5365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number63149-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: