Provider Demographics
NPI:1104314772
Name:DRAINS, MICHELLE KRISTEN (ND)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KRISTEN
Last Name:DRAINS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 NANNYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-9003
Mailing Address - Country:US
Mailing Address - Phone:732-233-4345
Mailing Address - Fax:
Practice Address - Street 1:151 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4732
Practice Address - Country:US
Practice Address - Phone:877-825-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-28
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0014175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath