Provider Demographics
NPI:1467174953
Name:DRAKE, MIKEL LINDSEY (RN)
Entity Type:Individual
Prefix:
First Name:MIKEL
Middle Name:LINDSEY
Last Name:DRAKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6329
Mailing Address - Country:US
Mailing Address - Phone:405-474-4420
Mailing Address - Fax:
Practice Address - Street 1:2900 MANOR RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6329
Practice Address - Country:US
Practice Address - Phone:405-474-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR008641163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKR008641OtherNONE