Individual
BRENDA KAY LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3717 BAY RD, ERIE, MI 48133-9404
(419) 297-4629
(734) 723-4001
Mailing address
3717 BAY RD, ERIE, MI 48133-9404
(419) 297-4629
(734) 723-4001
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
349091
OH
Other
Enumeration date
01/02/2013
Last updated
11/29/2019
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