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General NPI Number Information
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NPI Number | 1326146549
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Entity Type | Individual
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Provider Name | DEBORAH MARIE DRAKE CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 303 PARKWAY DR NE
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City | ATLANTA
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State | GA
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Zip | 30312-1212
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Country | US
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Telephone | 678-572-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 479 RISING STAR RD
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City | BROOKS
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State | GA
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Zip | 30205-1525
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Country | US
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Telephone | 678-572-7535
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9170541
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN219462
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License Number State | GA
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