Provider Demographics
NPI:1003997321
Name:DRAKE, DIANNA C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:C
Last Name:DRAKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHADYLAND DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8124
Mailing Address - Country:US
Mailing Address - Phone:865-584-5329
Mailing Address - Fax:865-212-9751
Practice Address - Street 1:284 MORRELL RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5876
Practice Address - Country:US
Practice Address - Phone:865-691-1153
Practice Address - Fax:865-691-8950
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist