Individual
MS. DATIA LEVON DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
648 CRESTWOOD BLVD, COVINGTON, LA 70433-8261
(985) 805-2555
Mailing address
42317 SEPTEMBER RAIN DR, HAMMOND, LA 70403-2115
(985) 634-2877
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
236145
LA
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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