Provider Demographics
NPI:1235848763
Name:DRAKE, DANA (RDN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 OAK POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CROPWELL
Mailing Address - State:AL
Mailing Address - Zip Code:35054-3551
Mailing Address - Country:US
Mailing Address - Phone:205-933-8101
Mailing Address - Fax:
Practice Address - Street 1:190 OAK POINTE DR
Practice Address - Street 2:
Practice Address - City:CROPWELL
Practice Address - State:AL
Practice Address - Zip Code:35054-3551
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL991133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered