Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 201907305NP | OR |
N | 363LA2200X | Nurse Practitioner - Adult Health | AP3708 | AZ |
NPI | 1003986696 |
---|---|
Provider Name | Cathryn Diann Draper |
First Address | Medford, OR 97504-4314 |
Second Address | Grants Pass, OR 97527-5535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 06/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9647686 | (05) | WA |