Provider Demographics
NPI:1306079702
Name:FRANKLIN, AMY RACHELLE (AMY FRANKLIN, PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RACHELLE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:AMY FRANKLIN, PA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5342 VILLAS DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6462
Mailing Address - Country:US
Mailing Address - Phone:336-202-4536
Mailing Address - Fax:
Practice Address - Street 1:690 PARKWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2487
Practice Address - Country:US
Practice Address - Phone:336-526-3500
Practice Address - Fax:336-526-3508
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant