Provider Demographics
NPI:1023727617
Name:DRAPER, MIKAILA MARIE (STNA)
Entity type:Individual
Prefix:
First Name:MIKAILA
Middle Name:MARIE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 20TH ST NW APT 1
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2146
Mailing Address - Country:US
Mailing Address - Phone:330-417-5744
Mailing Address - Fax:
Practice Address - Street 1:4721 20TH ST NW APT 1
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2146
Practice Address - Country:US
Practice Address - Phone:330-417-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602519940822376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide