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General NPI Number Information
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NPI Number | 1265321434
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Entity Type | Individual
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Provider Name | GINGER DRAKE NNP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 11 UPPER RIVERDALE ROAD 11 UPPER RIVERDALE ROAD
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City | RIVERDALE
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State | GA
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Zip | 30274
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Country | US
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Telephone | 470-856-2410
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Fax |
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Provider Business Mailing Address
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Address Line | 5220 FAIRMONT DR
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City | BEAUMONT
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State | TX
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Zip | 77706-2587
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Country | US
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Telephone | 855-222-9637
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Fax | 877-383-9267
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | RN213115
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License Number State | GA
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