Provider Demographics
NPI:1124452214
Name:DRAGO, CONNIE (RN)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:DRAGO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 CORDWELL CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-7135
Mailing Address - Country:US
Mailing Address - Phone:916-752-7427
Mailing Address - Fax:
Practice Address - Street 1:1525 PLUMAS CT
Practice Address - Street 2:SUITE C
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2971
Practice Address - Country:US
Practice Address - Phone:530-751-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311010163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health