Individual
MRS. NICOLE CHRISTINE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
317 S BROADWAY, CAMDEN, NJ 08103-1209
(856) 365-3519
Mailing address
317 S BROADWAY, CAMDEN, NJ 08103-1209
(856) 365-3519
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
26NR16488600
NJ
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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