Provider Demographics
NPI:1609514132
Name:DRAUTZ, INGRID (APRN)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:DRAUTZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SW 12TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3593
Mailing Address - Country:US
Mailing Address - Phone:954-339-6863
Mailing Address - Fax:
Practice Address - Street 1:555 SW 12TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3593
Practice Address - Country:US
Practice Address - Phone:954-339-6863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9190054163WW0000X
FLAPRN11020201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care