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NPI Code Detail

MEDICARE: DR. KELSEY LYNN DRAKE MD

MEDICARE: DR. KELSEY LYNN DRAKE MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianDR.0060543CO

General Provider Information

NPI Number : 1952667610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELSEY LYNN DRAKE MD
Provider Business Mailing Address
First Line : 9367 IRON MOUNTAIN WAY
Second Line :
City : ARVADA
State : CO
Zip : 80007-7721
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11600 W 2ND PL
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-1527
Country : US
Telephone Number : 720-321-4103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2012
Last Update Date : 12/23/2025

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