Healthcare Provider Details

I. General information

NPI: 1548146152
Provider Name (Legal Business Name): MICHELLE DRAKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 E EISENHOWER PKWY
ANN ARBOR MI
48108-3231
US

IV. Provider business mailing address

536 DESOTO AVE
YPSILANTI MI
48198-6116
US

V. Phone/Fax

Practice location:
  • Phone: 734-677-0070
  • Fax:
Mailing address:
  • Phone: 734-410-0155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: