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NPI Code Detail

MEDICARE: JUDITH DRAPER GNP, BC

MEDICARE: JUDITH DRAPER GNP, BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerVP001745HPA

General Provider Information

NPI Number : 1649429267
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH DRAPER GNP, BC
Provider Business Mailing Address
First Line : 4508 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3608
Country : US
Telephone Number : 215-746-2127
Fax Number : 215-746-7838
Provider Business Practice Location Address
First Line : 4508 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3608
Country : US
Telephone Number : 215-746-2127
Fax Number : 215-746-7838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 09/18/2008

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