Provider Demographics
NPI:1265143770
Name:FRANKO, JACQUELINE CHRISTY (PA-C)
Entity type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:CHRISTY
Last Name:FRANKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9696
Mailing Address - Fax:239-343-4198
Practice Address - Street 1:8960 COLONIAL CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7810
Practice Address - Country:US
Practice Address - Phone:239-343-9696
Practice Address - Fax:239-343-4198
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116675363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116748900Medicaid