Provider Demographics
NPI:1942872122
Name:DRAFFEN, MEGAN RENEE (PT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:DRAFFEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4515 POTTER CT
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8713
Mailing Address - Country:US
Mailing Address - Phone:270-556-1872
Mailing Address - Fax:
Practice Address - Street 1:115 KIANA CT
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6787
Practice Address - Country:US
Practice Address - Phone:270-534-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist