Provider Demographics
NPI:1861851776
Name:BECKMAN-DRAHT, KYM (RN)
Entity Type:Individual
Prefix:
First Name:KYM
Middle Name:
Last Name:BECKMAN-DRAHT
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 1:1250 MOUNT ZOAR RD
Mailing Address - Street 2:
Mailing Address - City:PINE CITY
Mailing Address - State:NY
Mailing Address - Zip Code:14871-9549
Mailing Address - Country:US
Mailing Address - Phone:607-734-7107
Mailing Address - Fax:
Practice Address - Street 1:1250 MOUNT ZOAR RD
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:NY
Practice Address - Zip Code:14871-9549
Practice Address - Country:US
Practice Address - Phone:607-734-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY368016-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health