Provider Demographics
NPI:1417404856
Name:DRAKE, PATTY (RN BSN)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261612
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-1612
Mailing Address - Country:US
Mailing Address - Phone:469-988-8264
Mailing Address - Fax:972-767-3545
Practice Address - Street 1:5068 W PLANO PKWY
Practice Address - Street 2:SUITE 366
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4408
Practice Address - Country:US
Practice Address - Phone:469-988-8264
Practice Address - Fax:972-767-3545
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509519163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health