Healthcare Provider Details

I. General information

NPI: 1871410456
Provider Name (Legal Business Name): CHRISTOPHER DRAKE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3547 HENDRICKS AVE
JACKSONVILLE FL
32207-5309
US

IV. Provider business mailing address

1406 LANTERN LIGHT TRL
MIDDLEBURG FL
32068-8733
US

V. Phone/Fax

Practice location:
  • Phone: 904-877-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11048848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: