Basic Information
Provider Information
NPI: 1679017693
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANZMEIER
FirstName: CARMEN
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: 8170 33RD AVE S # MS 21110Q
Address2:  
City: BLOOMINGTON
State: MN
PostalCode: 554254516
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 8550 HUDSON BLVD N
Address2:  
City: LAKE ELMO
State: MN
PostalCode: 550425500
CountryCode: US
TelephoneNumber: 9529936200
FaxNumber: 6512540601
Other Information
ProviderEnumerationDate: 12/09/2016
LastUpdateDate: 11/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X4222MNY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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