MEDICARE: DR. JENNIFER STEVENS DRAPP BS DC

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
1	111N00000X	Chiropractor	CH8410	FL
2	111N00000X	Chiropractor	CHIR008130	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89035	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1972502771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER STEVENS DRAPP BS DC

Provider Business Mailing Address
First Line	:	6467 BARTON CREEK CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6548
Country	:	US
Telephone Number	:	407-913-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1054 GATEWAY BLVD
Second Line	:	SUITE 110
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33463
Country	:	US
Telephone Number	:	407-913-0001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/29/2009

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