Doctor Name: | MINDY JEAN DRAKE |
NPI Number: | 1245534627 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 161365147 |
Business Practice Address: | 94 N Main St Suite 104 Wellsville, NY - 148951250 |
Business Phone Number: | 5855939410 |
Business Fax Number: | 5855939411 |
Mailing Address: | 138 S Broad St, WELLSVILLE |
State: | NY |
Postal Code: | 148951608 |
Phone Number: | 5855939410 |
Fax Number: | 5855939411 |
NPI Enumeration Date: | 12/29/2010 |
NPI Last Update Date: | 12/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 161365147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |