Individual
MRS. ELISE CHRISTINE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS AVE, WICHITA, KS 67214-3821
(316) 268-5000
Mailing address
460 TURKLE AVE, HAYSVILLE, KS 67060-1709
(316) 796-6314
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
149139
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
43-558319-041
KS
Other
Enumeration date
04/08/2025
Last updated
08/21/2025
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