Individual
KIMBERLY O DRAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LNM
Contact information
Practice address
1131 WEST ST, BLDG 2, SOUTHINGTON, CT 06489-6006
(860) 276-6800
Mailing address
1131 WEST ST, BLDG 2, SOUTHINGTON, CT 06489-6006
(860) 276-6800
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000285
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000285
LICENSE
—
Enumeration date
09/18/2013
Last updated
09/18/2013
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