Healthcare Provider Details

I. General information

NPI: 1982281648
Provider Name (Legal Business Name): KAREN DREW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 01/10/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 PETERS CREEK RD STE 110
ROANOKE VA
24019-4060
US

IV. Provider business mailing address

PREMIER GERIATRIC SOLUTIONS 6701 PETERS CREEK ROAD SUITE 110
ROANOKE VA
24019-7447
US

V. Phone/Fax

Practice location:
  • Phone: 800-765-7130
  • Fax:
Mailing address:
  • Phone: 800-765-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024180575
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: