Individual
MS. MEREDITH ROSE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
Mailing address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
6861
CT
Other
Enumeration date
12/01/2016
Last updated
09/15/2022
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