Healthcare Provider Details

I. General information

NPI: 1831118421
Provider Name (Legal Business Name): RACHAEL E DRAKE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL E BARONOWSKY R.N.

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 VENETIAN WAY STE 200
NEWBURGH IN
47630-8257
US

IV. Provider business mailing address

3800 VENETIAN WAY
NEWBURGH IN
47630-8257
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-6103
  • Fax: 812-477-4897
Mailing address:
  • Phone: 812-469-3283
  • Fax: 812-469-3285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number71002059A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: