Provider Demographics
NPI:1245255983
Name:DRAKE, SHEENA S (MD)
Entity type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:S
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HEARTLAND RD STE 2800
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-6201
Mailing Address - Country:US
Mailing Address - Phone:816-271-1200
Mailing Address - Fax:
Practice Address - Street 1:901 HEARTLAND RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-6200
Practice Address - Country:US
Practice Address - Phone:816-271-1085
Practice Address - Fax:816-271-1216
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001012416207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
414780OtherFIRSTGUARD
MO465450OtherCHILDRENS MERCY FAMILY HEALTH
44054528964506V019OtherCHAMPUS/TRICARE
7482263OtherAETNA
P00037736OtherRAILROAD MEDICARE
MO29840029OtherBLUE CROSS BLUE SHIELD
KS100401700BMedicaid
477436OtherHEALTHLINK
10001554801OtherCOMMUNITY HEALTH PLAN
MO205362700Medicaid
44054528964506V019OtherCHAMPUS/TRICARE
P00037736OtherRAILROAD MEDICARE