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General NPI Number Information
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NPI Number | 1194579243
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Entity Type | Individual
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Provider Name | JAIME NICOLE FRANKLIN
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 6743 ACADEMY RD NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3372
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Country | US
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Telephone | 505-717-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 11204 KIELICH AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1844
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Country | US
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Telephone | 505-860-4192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA0821
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License Number State | NM
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