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General NPI Number Information
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NPI Number | 1982114252
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Entity Type | Individual
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Provider Name | TRACEY LASHAY FRANKLIN APRN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 100 WALCO LN
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City | MALVERN
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State | AR
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Zip | 72104-6793
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Country | US
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Telephone | 501-337-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 30 AYLA DR APT B106
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4768
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Country | US
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Telephone | 870-692-7817
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A005311
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License Number State | AR
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