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Contact Information

MARISSA DRAKE, CNP
2004 FORD PKWY
SAINT PAUL, MN55116-1931
 Phone: 612-256-8225
 Fax: 612-457-0216
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Medical-Surgical

163WM0705X
Indicates primary specialty

NPI Profile & details for MARISSA DRAKE · (Female)

NPI # 1124438734
Status Active
Credentials CNP (Certified Nurse Practitioner)
Entity Individual
Enumeration date 05/05/2014
Last updated 09/14/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 2407
  • MN License # R 185046-6
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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