Basic Information
| Provider Information | |||||||||
| NPI: | 1679813976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANKLIN | ||||||||
| FirstName: | JEANNIE | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 4TH ST | ||||||||
| Address2: | SUITE 501 | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511011750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122340220 | ||||||||
| FaxNumber: | 7122340225 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 4TH ST | ||||||||
| Address2: | SUITE 501 | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511011750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122340220 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2013 | ||||||||
| LastUpdateDate: | 02/25/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | G095559 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 364S00000X | G095559 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
ID Information
| ID | Type | State | Issuer | Description | G095559 | 01 | IA | ARNP LICENSE | OTHER |