Healthcare Provider Details

I. General information

NPI: 1164471926
Provider Name (Legal Business Name): JOSEPH D. DRAWDY APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E MAIN ST
SALEM KY
42078-9998
US

IV. Provider business mailing address

302 MICBETH DR
PRINCETON KY
42445-6332
US

V. Phone/Fax

Practice location:
  • Phone: 270-988-3839
  • Fax: 270-988-3832
Mailing address:
  • Phone: 270-365-1225
  • Fax: 270-365-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number0242744-23
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3002206
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: