Individual
CHRISTINA R LAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1350 CHESTER BLVD STE B, RICHMOND, IN 47374-1962
(765) 935-4088
(765) 966-2596
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SVCS, RICHMOND, IN 47374-1157
(765) 935-4088
(765) 966-2596
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007359A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001112412
ANTHEM
IN
01
—
259370222
MEDICARE
IN
05
—
300009485
—
IN
Enumeration date
11/29/2012
Last updated
07/08/2022
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