Individual
ANNE F. LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
6447 MUDDY CREEK RD, ARCHDALE, NC 27263-3925
(336) 688-1162
Mailing address
6447 MUDDY CREEK RD, ARCHDALE, NC 27263-3925
(336) 688-1162
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0002-01480
NC
363LF0000X
Family Nurse Practitioner
Primary
201480
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500025121
RAILROAD MEDICARE
NC
05
—
7004786
—
NC
01
—
P00762134
RAILROAD MEDICARE
NC
Enumeration date
01/20/2006
Last updated
09/20/2013
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