Individual
DR. ELIZABETH PAGE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3169
Mailing address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3169
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-13989
MS
1835P1300X
Psychiatric Pharmacist
Primary
E-13989
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02920825
—
MS
Enumeration date
12/12/2014
Last updated
03/15/2023
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