MEDICARE: ANGELIQUE FRANKLIN 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	164W00000X	Licensed Practical Nurse	LP54195	MD

General Provider Information

NPI Number	:	1255087623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIQUE FRANKLIN LPN

Provider Business Mailing Address
First Line	:	1818 GRAYMOUNT WAY
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-3011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 GRAYMOUNT WAY
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-3011
Country	:	US
Telephone Number	:	443-910-7466
Fax Number	:

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

Provider Enumeration Date	:	02/24/2022
Last Update Date	:	02/24/2022

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