Provider Demographics
NPI:1326345141
Name:DRABING, SUSAN GRACE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:GRACE
Last Name:DRABING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-2847
Mailing Address - Country:US
Mailing Address - Phone:618-667-6599
Mailing Address - Fax:618-667-6599
Practice Address - Street 1:320 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-2704
Practice Address - Country:US
Practice Address - Phone:618-624-3368
Practice Address - Fax:618-624-3387
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008650041254438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily