Provider Demographics
NPI:1245020536
Name:DRAPER, JESSICA RAE (MSCN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:DRAPER
Suffix:
Gender:
Credentials:MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 CALLE DEL SUR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3437
Mailing Address - Country:US
Mailing Address - Phone:253-375-5501
Mailing Address - Fax:
Practice Address - Street 1:1309 CALLE DEL SUR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7991
Practice Address - Country:US
Practice Address - Phone:253-375-5501
Practice Address - Fax:253-375-5501
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education