MARISSA DRAKE CNP NPI 1124438734

NPI Information

NPI: 1124438734
Provider Name: MARISSA DRAKE, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2004 FORD PKWY
SAINT PAUL, MN
ZIP 55116
Phone: (612) 256-8225
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Marissa Drake, CNP is a family nurse practitioner in Saint Paul, MN with 10 years of experience. Marissa Drake, CNP NPI is 1124438734. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2004 FORD PKWY
SAINT PAUL, MN
ZIP 55116-931
Phone: (612) 256-8225
Fax: (612) 457-0216

The NPI 1124438734 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/5/2014 and was last updated on 9/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WM0705X	Registered Nurse	Medical-Surgical	R 185046-6	MINNESOTA	No
2	363LF0000X	Nurse Practitioner	Family	R 185046-6	MINNESOTA	No
3	363LF0000X	Nurse Practitioner	Family	2407	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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