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Individual

ALEXANDRA K DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 549-2500
(318) 227-3359
Mailing address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 549-2500
(318) 227-3359

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP06323
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
131206
RN STATE LICENSE
LA
05
2135970
LA
01
AP06323
PMHNP LICENSE
LA
Enumeration date
11/11/2010
Last updated
09/08/2011
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