Individual
KELLY LEE DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5467 UPPER MOUNTAIN RD STE 100, LOCKPORT, NY 14094-1894
(716) 804-3613
Mailing address
5467 UPPER MOUNTAIN RD STE 100, LOCKPORT, NY 14094-1894
(716) 804-3613
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
473716-01
NY
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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