Provider Demographics
NPI:1063142966
Name:FRANCE, CHARLIE JAMES II (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHARLIE
Middle Name:JAMES
Last Name:FRANCE
Suffix:II
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-8307
Mailing Address - Country:US
Mailing Address - Phone:606-939-2032
Mailing Address - Fax:
Practice Address - Street 1:THREE RIVERS MEDICAL CENTER
Practice Address - Street 2:HWY 644
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230
Practice Address - Country:US
Practice Address - Phone:606-638-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3016861OtherKENTUCKY BOARD OF NURSING