Individual
MICHELLE LAKE
Active
Individual
MICHELLE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041439972
IL
163W00000X
Registered Nurse
141908
IA
363LA2100X
Acute Care Nurse Practitioner
Primary
H171781
IA
Other
Enumeration date
08/24/2022
Last updated
07/13/2023
Update your record
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