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NPI Code Detail

MEDICARE: IVONNE DRAUGHON DNP

MEDICARE: IVONNE DRAUGHON DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5005568NC
2363LF0000XFamily Nurse Practitioner5005568NC
3363L00000XNurse PractitionerAPRN002553NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15005568OTHERNCNC BOARD OF NURSING
2APRN002553OTHERNVNV BOARD OF NURSING

General Provider Information

NPI Number : 1861752701
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVONNE DRAUGHON DNP
Provider Business Mailing Address
First Line : 2797 NC HIGHWAY 55
Second Line :
City : CARY
State : NC
Zip : 27519-0000
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-652-9787
Provider Business Practice Location Address
First Line : 1200 S 4TH ST STE 111
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1046
Country : US
Telephone Number : 702-380-8118
Fax Number : 702-380-2929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2012
Last Update Date : 12/20/2017

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