Individual
JESSICA LAUREN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1494 LAKE MURRAY BLVD, COLUMBIA, SC 29212
(803) 764-0464
Mailing address
1494 LAKE MURRAY BLVD, COLUMBIA, SC 29212-8697
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011330
KY
Other
Enumeration date
07/14/2017
Last updated
08/03/2017
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