Provider Demographics
NPI:1710651823
Name:DRAPER, ELIZABETH ELLEN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:DRAPER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 S 86TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9277
Mailing Address - Country:US
Mailing Address - Phone:402-489-7806
Mailing Address - Fax:
Practice Address - Street 1:4525 S 86TH ST STE A
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9277
Practice Address - Country:US
Practice Address - Phone:402-489-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1306124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist