MEDICARE: MRS. CAMILLE J FRANK LPN

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	164X00000X	Licensed Vocational Nurse	PN. 126079	OH

General Provider Information

NPI Number	:	1164773792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAMILLE J FRANK LPN

Provider Business Mailing Address
First Line	:	5044 HAVERFIELD RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45432-3502
Country	:	US
Telephone Number	:	937-256-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	5044 HAVERFIELD RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45432-3502
Country	:	US
Telephone Number	:	937-256-2224
Fax Number	:

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

Provider Enumeration Date	:	09/22/2012
Last Update Date	:	09/22/2012

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