Individual
KIM DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S 9TH ST, PHILADELPHIA, PA 19107-5125
(215) 985-2562
Mailing address
260 S BROAD ST, PHILADELPHIA, PA 19102-5021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN335376L
PA
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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