Individual
JESSICA ANN LAKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2070 BIDDLE AVE, SUITE 200, WYANDOTTE, MI 48192-4080
(734) 225-9100
(734) 225-9176
Mailing address
2070 BIDDLE AVE STE 200, WYANDOTTE, MI 48192-4080
(734) 225-9100
(734) 225-9179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704249683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28865
BLUE CROSS
MI
01
—
1144634403
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
03/28/2011
Last updated
04/16/2021
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