Provider Demographics
NPI:1972502771
Name:DRAPP, JENNIFER STEVENS (BS DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:STEVENS
Last Name:DRAPP
Suffix:
Gender:F
Credentials:BS DC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS DC
Mailing Address - Street 1:6467 BARTON CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6548
Mailing Address - Country:US
Mailing Address - Phone:407-913-0001
Mailing Address - Fax:
Practice Address - Street 1:1054 GATEWAY BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:407-913-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8410111N00000X
GACHIR008130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89035OtherBCBS