Healthcare Provider Details

I. General information

NPI: 1871213926
Provider Name (Legal Business Name): REANNA F DRAPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REANNA F BEGAY

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORNER OF ROUTES N12 & N7
FORT DEFIANCE AZ
86504
US

IV. Provider business mailing address

PO BOX 649
FORT DEFIANCE AZ
86504-0649
US

V. Phone/Fax

Practice location:
  • Phone: 928-729-8000
  • Fax:
Mailing address:
  • Phone: 928-729-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number88418
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-84115
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number249909
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: