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Individual

KIRSTEN R DRAKULICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7000 STONEWOOD DR, STE 151, WEXFORD, PA 15090-7376
(724) 933-0300
(724) 933-0456
Mailing address
7000 STONEWOOD DR, STE 151, WEXFORD, PA 15090-7376

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054522
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
251879554
TAX ID
PA
Enumeration date
12/15/2010
Last updated
05/16/2016
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