Provider Demographics
NPI:1285324418
Name:FRANKLIN, GALISA (CP)
Entity type:Individual
Prefix:
First Name:GALISA
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 GOODMAN RD APT 3503
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1876
Mailing Address - Country:US
Mailing Address - Phone:901-724-5105
Mailing Address - Fax:
Practice Address - Street 1:9400 GOODMAN RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1733
Practice Address - Country:US
Practice Address - Phone:901-724-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy