=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770550493
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | COLLEEN L FRANK CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2006
-----------------------------------------------------
Last Update Date | 05/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45 N CANFIELD NILES RD
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44515-2343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-792-2722
-----------------------------------------------------
Fax | 330-793-2587
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 N CANFIELD NILES RD
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44515-2343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-792-2722
-----------------------------------------------------
Fax | 330-793-2587
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | RN-229081
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------