Provider Demographics
NPI:1154973451
Name:FRANCK, JIMSON
Entity type:Individual
Prefix:
First Name:JIMSON
Middle Name:
Last Name:FRANCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 HUNTING MEADOWS CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-2460
Mailing Address - Country:US
Mailing Address - Phone:719-217-2518
Mailing Address - Fax:
Practice Address - Street 1:4330 HUNTING MEADOWS CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-2460
Practice Address - Country:US
Practice Address - Phone:719-217-2518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No372600000XNursing Service Related ProvidersAdult Companion