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Individual
ANTHONY LAKE
Active
Individual
ANTHONY LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6581
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6581
TN
Other
Enumeration date
07/03/2006
Last updated
10/29/2014
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