Individual
KIMBERLY A DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1151 BARATARIA BLVD, MARRERO, LA 70072-3044
(504) 349-6401
Mailing address
1151 BARATARIA BLVD, MARRERO, LA 70072-3044
(504) 349-6401
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
905286
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
AP04449
LA
363LF0000X
Family Nurse Practitioner
905286
MS
363LF0000X
Family Nurse Practitioner
RN061743
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05809264
—
MS
05
—
1461083
—
LA
Enumeration date
05/01/2006
Last updated
04/20/2023
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