Basic Information
| Provider Information | |||||||||
| NPI: | 1730597501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANKLIN | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 W WHITE RIVER BLVD | ||||||||
| Address2: | |||||||||
| City: | MUNCIE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473034988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8776685621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 S HOKE AVE | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460412664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656591110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2014 | ||||||||
| LastUpdateDate: | 02/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 28175550A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 363LP0200X | 71005077A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000000894654 | 01 | IN | ANTHEM PROVIDER NUMBER | OTHER | 201250340 | 05 | IN | MEDICAID |