Basic Information
| Provider Information | |||||||||
| NPI: | 1881615896 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRAPER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | B. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 AFFLINK PL | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354062289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053669740 | ||||||||
| FaxNumber: | 2053449992 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 MCFARLAND BLVD N | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354062209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053458208 | ||||||||
| FaxNumber: | 2053458209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 08/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1-045212 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 051553208 | 05 | AL | MEDICAID | P00023513 | 01 | AL | RAILROAD MEDICARE | OTHER | 51515612 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 51514279 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 51515543 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 891005330 | 05 | AL | MEDICAID |