Provider Demographics
NPI:1124755681
Name:DRAYNA, ELIZABETH (BSRN, CDCES)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DRAYNA
Suffix:
Gender:F
Credentials:BSRN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 E 8085 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6628
Mailing Address - Country:US
Mailing Address - Phone:614-599-2482
Mailing Address - Fax:
Practice Address - Street 1:1140 E 3900 S STE 390
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1256
Practice Address - Country:US
Practice Address - Phone:801-743-4700
Practice Address - Fax:801-743-4700
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT32200087163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator