Provider Demographics
NPI:1861094864
Name:FRANKO, EDNA BREWBAKER (RD, CDCES)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:BREWBAKER
Last Name:FRANKO
Suffix:
Gender:F
Credentials:RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 WILLOW OAK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3178
Mailing Address - Country:US
Mailing Address - Phone:336-340-7473
Mailing Address - Fax:
Practice Address - Street 1:3008 WILLOW OAK DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3178
Practice Address - Country:US
Practice Address - Phone:336-340-7473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002569133V00000X
NC85007598133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered