Individual
LISA ANN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1225 S GEAR AVE, SUITE 159, WEST BURLINGTON, IA 52655-1691
(319) 768-1570
Mailing address
1225 S GEAR AVE STE 159, WEST BURLINGTON, IA 52655-1686
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A120202
IA
Other
Enumeration date
06/16/2015
Last updated
08/20/2025
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