Healthcare Provider Details

I. General information

NPI: 1124301643
Provider Name (Legal Business Name): ANGELA DAWN FRANKFORT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 63 BOX 2580
ROMNEY WV
26757-9718
US

IV. Provider business mailing address

HC 63 BOX 2580
ROMNEY WV
26757-9718
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-7527
  • Fax:
Mailing address:
  • Phone: 304-822-7527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberPTA001560
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: