Healthcare Provider Details

I. General information

NPI: 1093075186
Provider Name (Legal Business Name): DRAKE EYE CARE AND EYEWEAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 VETERANS PKWY SUITE E
MURFREESBORO TN
37128-6435
US

IV. Provider business mailing address

220 VETERANS PKWY SUITE E
MURFREESBORO TN
37128-6435
US

V. Phone/Fax

Practice location:
  • Phone: 615-907-2030
  • Fax: 615-907-2356
Mailing address:
  • Phone: 615-907-2030
  • Fax: 615-907-2356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2827
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JENNIFER B DRAKE
Title or Position: OD/OWNER
Credential: OD
Phone: 615-907-2030