Individual
MRS. HEIDI LYNN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
917 TUSCALOOSA AVE SW, BIRMINGHAM, AL 35211-1618
(205) 783-9330
Mailing address
917 TUSCALOOSA AVE SW, BIRMINGHAM, AL 35211-1618
(205) 783-9330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA363
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529909750
—
AL
Enumeration date
10/18/2006
Last updated
11/17/2008
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