Provider Demographics
NPI:1265909709
Name:DRAPER, AGATA E (APN)
Entity type:Individual
Prefix:
First Name:AGATA
Middle Name:E
Last Name:DRAPER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6725 VENTNOR AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-2166
Mailing Address - Country:US
Mailing Address - Phone:609-350-3780
Mailing Address - Fax:609-350-6995
Practice Address - Street 1:2106 NEW RD STE D4
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1050
Practice Address - Country:US
Practice Address - Phone:609-926-8899
Practice Address - Fax:609-926-6474
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00868700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily