Individual
LEA DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 438-1865
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 438-1865
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704245510
MI
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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