1003864455 NPI number — ELDA RAE FRANCIS CFNP-RN-MSN

Table of content: ELDA RAE FRANCIS CFNP-RN-MSN (NPI 1003864455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003864455 NPI number — ELDA RAE FRANCIS CFNP-RN-MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCIS
Provider First Name:
ELDA
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CFNP-RN-MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003864455
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1775 FM 195
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-739-2700
Provider Business Mailing Address Fax Number:
903-739-9731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1775 FM 195
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-739-2700
Provider Business Practice Location Address Fax Number:
903-739-9731
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  242968 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0425001-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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