Miranda Drake
Individual provider Active NPI Licensed Practical Nurse · Dansville, NY
NPI 1093481277 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1093481277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 341985-01 (NY)
- Practice address
- 45 Maple St
Dansville, NY 14437-9182 - Phone
- (585) 335-5052
- NPI assigned
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 341985-01 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Casa-Trinity, Inc. | Past |
Accepting new patients | |
| Casa-Trinity, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 341985-01 | NY | Yes |
Addresses
Primary practice location
45 Maple St
Dansville, NY 14437-9182
Mailing address
4373 State Route 19 S
Belmont, NY 14813-9513
Phone (585) 610-8560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16-1039939 | Medicaid | NY | |
| 16-1039939 | Other | NY | ALL OTHER INSURANCES |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdrake@casa-trinity.org |
Other providers in Dansville, NY
- Diane Dobnack
- Jennifer Domagalski
- Jennifer Irene Donatella
- Robert P Dougherty
- Erin Douthit
- Kate M. Driscoll
- Donald Dunac
- Sarah S Easton
- Kathryn Violet Edwards
- Mervat Eid
All providers in Dansville, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.