Individual
MATTHEW LEWIS DRAPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C, RN, AT, ATC
Contact information
Practice address
956 COOPER ST, JACKSON, MI 49202-3398
(517) 998-6574
Mailing address
11228 SAND HILL DR, GRASS LAKE, MI 49240-9688
(517) 398-4042
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
4704318832
MI
2255A2300X
Athletic Trainer
2601000140
MI
363LF0000X
Family Nurse Practitioner
Primary
4704318832
MI
Other
Enumeration date
11/17/2011
Last updated
03/26/2024
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