Individual
DIANA DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
606 24TH AVE S, SUITE 300, MINNEAPOLIS, MN 55454-1455
(612) 273-7111
Mailing address
420 DELAWARE ST SE, MMC 395, MINNEAPOLIS, MN 55455-0341
(612) 626-3111
(612) 626-0665
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R100675-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R100675-7
RN LICENSING BOARD
MN
Enumeration date
01/30/2012
Last updated
06/05/2014
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