Individual
MR. JAMES BRYAN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
701 DOCTORS DR STE N, KINSTON, NC 28501-1584
(252) 559-2200
(252) 523-7642
Mailing address
1016 SEDBROOK LN, WINTERVILLE, NC 28590-6008
(252) 916-4443
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
LAKE-2S9JB
NC
363LP2300X
Primary Care Nurse Practitioner
Primary
LAKE-2S9JB
NC
Other
Enumeration date
06/27/2023
Last updated
10/05/2023
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