Individual
CHARLOTTE R DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1264 WESLEY DR, SUITE 501, MEMPHIS, TN 38116-6400
(901) 346-1800
(901) 346-0043
Mailing address
7163 GOODMAN RD, OLIVE BRANCH, MS 38654-1904
(662) 895-3700
(662) 895-4886
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18717
TN
363LF0000X
Family Nurse Practitioner
Primary
R867991
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01685008
—
MS
Enumeration date
06/01/2010
Last updated
03/07/2023
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