Basic Information
Provider Information
NPI: 1487274007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: HEATHER
MiddleName: ROSE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PEDIATRIC EDUCATION OFFICE CB 7593
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275997593
CountryCode: US
TelephoneNumber: 9199663172
FaxNumber: 9199668419
Practice Location
Address1: 118 KNOX WAY
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275166610
CountryCode: US
TelephoneNumber: 9842155900
FaxNumber: 9842155942
Other Information
ProviderEnumerationDate: 04/23/2020
LastUpdateDate: 04/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X261461NCY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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