Individual
KRISTINE DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
9124 W ROMA AVE, PHOENIX, AZ 85037-0814
(586) 907-7151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9332
AZ
Other
Enumeration date
10/05/2022
Last updated
10/20/2022
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