Provider Demographics
NPI:1518206515
Name:DRAKE, AMBER N (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:N
Last Name:DRAKE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-4805
Mailing Address - Country:US
Mailing Address - Phone:260-417-0318
Mailing Address - Fax:
Practice Address - Street 1:6819 BUTTERNUT LN
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-4805
Practice Address - Country:US
Practice Address - Phone:260-417-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula