Provider Demographics
NPI:1922828664
Name:DRAPER, FLOSSIE MARIE (NP)
Entity type:Individual
Prefix:
First Name:FLOSSIE
Middle Name:MARIE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-9670
Mailing Address - Country:US
Mailing Address - Phone:502-525-8102
Mailing Address - Fax:
Practice Address - Street 1:185 ADAM SHEPHERD PKWY
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6578
Practice Address - Country:US
Practice Address - Phone:502-525-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4030095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily