Healthcare Provider Details

I. General information

NPI: 1578208229
Provider Name (Legal Business Name): JENNIFER MARIE DRAPER ACCNS-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

786 BRADFORD TER
SPRINGFIELD PA
19064-3909
US

V. Phone/Fax

Practice location:
  • Phone: 215-221-9721
  • Fax:
Mailing address:
  • Phone: 262-210-6820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberCNS000283
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: