MEDICARE: MS. YOLONDA DELLINE FRANKLIN IDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1114139185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YOLONDA DELLINE FRANKLIN IDC

Provider Business Mailing Address
First Line	:	112 SIGNATURE WAY APT 1133
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-5948
Country	:	US
Telephone Number	:	757-537-8629
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS DWIGHT D EISENHOWER CVN 69
Second Line	:	MEDICAL DEPT
City	:	FPO
State	:	AE
Zip	:	09532 2380
Country	:	US
Telephone Number	:	757-445-3037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	04/20/2008

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