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Individual
STACEY L DRAPER
Active
Individual
STACEY L DRAPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28191280A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008945A
IN
363LF0000X
Family Nurse Practitioner
F03190067
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176390007
MEDICARE PTAN
IN
05
—
300027411
—
IN
Enumeration date
03/19/2019
Last updated
10/23/2023
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