Provider Demographics
NPI:1992465017
Name:FRANKLIN, GLENDA M (BSN-RN)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:M
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W TOKAY ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-3850
Mailing Address - Country:US
Mailing Address - Phone:925-579-4018
Mailing Address - Fax:
Practice Address - Street 1:1111 W TOKAY ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-3850
Practice Address - Country:US
Practice Address - Phone:925-579-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA666784163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse