Provider Demographics
NPI:1831118421
Name:DRAKE, RACHAEL E (NP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:E
Last Name:DRAKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:E
Other - Last Name:BARONOWSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3800 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8257
Mailing Address - Country:US
Mailing Address - Phone:812-469-3283
Mailing Address - Fax:812-469-3285
Practice Address - Street 1:3800 VENETIAN WAY
Practice Address - Street 2:STE 200
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8257
Practice Address - Country:US
Practice Address - Phone:812-477-6103
Practice Address - Fax:812-477-4897
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002059A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200805860Medicaid