Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP015123 | PA |
NPI | 1003291618 |
---|---|
Provider Name | Ashley N Draper |
First Address | Lancaster, PA 17602-2374 |
Second Address | Lancaster, PA 17602-2374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2015 |
Last Update Date | 26/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103162266 | (05) | PA |