Provider Demographics
NPI:1861204372
Name:DRAKE, ALISHA
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 GENTRY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5404
Mailing Address - Country:US
Mailing Address - Phone:614-946-5863
Mailing Address - Fax:
Practice Address - Street 1:2906 GENTRY LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5404
Practice Address - Country:US
Practice Address - Phone:614-946-5863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUA224810172A00000X
OH253Z00000X, 372600000X, 251E00000X
OHLPN.160790.MEDS-IV251J00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No172A00000XOther Service ProvidersDriver
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care