Basic Information
Provider Information
NPI: 1205208295
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPPE
FirstName: DREW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5629
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477165629
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Practice Location
Address1: 415 CROSSLAKE DR
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477158263
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Other Information
ProviderEnumerationDate: 10/29/2015
LastUpdateDate: 10/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X31005530AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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