Individual
MRS. ELISSA SUZANNE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDEM, CPM
Contact information
Practice address
1660 W ANTELOPE DR, LAYTON, UT 84041-1156
(801) 917-6104
Mailing address
703 N 1050 W, CLEARFIELD, UT 84015-9331
(801) 686-0154
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
6225016-3400
UT
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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