Organization
LAKES DERMATOLOGY, PLLC
Active
Other names
Lakes Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL ELIZABETH MEYER ARNP (OWNER)
(712) 336-2728
Entity
Organization
Contact information
Practice address
2704 ENTERPRISE AVE, SPIRIT LAKE, IA 51360
(712) 336-2728
(712) 336-2842
Mailing address
2704 ENTERPRISE AVE, SPIRIT LAKE, IA 51360
(712) 336-2728
(712) 336-2842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A-118055
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841548161
INDIVIDUAL NPI
IA
Enumeration date
03/08/2016
Last updated
12/21/2022
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