Provider Demographics
NPI:1649547803
Name:DRAPER, RACHEL A (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:DRAPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 HAZELNUT DR
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6196
Mailing Address - Country:US
Mailing Address - Phone:423-737-5342
Mailing Address - Fax:
Practice Address - Street 1:127 HAZELNUT DR
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-6196
Practice Address - Country:US
Practice Address - Phone:423-737-5342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16213363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527140Medicaid
TN10350I5465Medicare PIN