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Organization
LAKES DERMATOLOGY, PLLC
Active
Organization
LAKES DERMATOLOGY, PLLC
Active
Other names
Lakes Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL ELIZABETH MEYER ARNP (OWNER)
(712) 336-2728
Entity
Organization
Contact information
Practice address
2704 ENTERPRISE AVE, SPIRIT LAKE, IA 51360
(712) 336-2728
(712) 336-2842
Mailing address
2704 ENTERPRISE AVE, SPIRIT LAKE, IA 51360
(712) 336-2728
(712) 336-2842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A-118055
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841548161
INDIVIDUAL NPI
IA
Enumeration date
03/08/2016
Last updated
12/21/2022
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