Provider Demographics
NPI:1083827042
Name:DRAKE, ELIZABETH (EDD, LAT, ATC)
Entity Type:Individual
Prefix:PROF
First Name:ELIZABETH
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:EDD, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-1485
Mailing Address - Country:US
Mailing Address - Phone:651-335-7913
Mailing Address - Fax:
Practice Address - Street 1:1400 HIGHLAND CTR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6537
Practice Address - Country:US
Practice Address - Phone:507-389-1656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer