Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 31018 | IA |
NPI | 1083688568 |
---|---|
Provider Name | Karen L Drake |
First Address | Des Moines, IA 50314-1728 |
Second Address | Des Moines, IA 50314-1728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 16/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0133546 | (05) | IA |
F35539 | (02) |