Provider Demographics
NPI:1174576227
Name:FRANKS, VIRGINIA G (CRNA)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:G
Last Name:FRANKS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CIRCLE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1823
Mailing Address - Country:US
Mailing Address - Phone:913-961-0415
Mailing Address - Fax:
Practice Address - Street 1:2 CIRCLE CREEK WAY
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1823
Practice Address - Country:US
Practice Address - Phone:913-961-0415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28181596A367500000X
MO2001000464367500000X
KS43-55513-111367500000X
KS1385665111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200919140Medicaid
MO1174576227Medicaid
KS200381440CMedicaid
IN000000734003OtherANTHEM PROVIDER NUMBER
KS200381440CMedicaid
MO1174576227Medicaid
IN200919140Medicaid