Provider Demographics
NPI:1194346817
Name:FRANK, RONNETTE
Entity type:Individual
Prefix:
First Name:RONNETTE
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 PARKER RD SE STE 210
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6654
Mailing Address - Country:US
Mailing Address - Phone:770-731-7700
Mailing Address - Fax:
Practice Address - Street 1:1775 PARKER RD SE STE 210
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6654
Practice Address - Country:US
Practice Address - Phone:770-731-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN182111163WC1500X, 174H00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No174H00000XOther Service ProvidersHealth Educator