Healthcare Provider Details

I. General information

NPI: 1205622792
Provider Name (Legal Business Name): MONIQUE DRAYER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 COCOA AVE
HERSHEY PA
17033-1712
US

IV. Provider business mailing address

6193 SPRING KNOLL DR
HARRISBURG PA
17111-6863
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-6015
  • Fax:
Mailing address:
  • Phone: 717-512-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN601653
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: