Individual
SHARON G. LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
4607 MACCORKLE AVE SW, SUITE 300, SOUTH CHARLESTON, WV 25309-1364
(304) 766-3688
(304) 766-3484
Mailing address
204 STONE PL, SCOTT DEPOT, WV 25560-9465
(304) 539-1298
(304) 766-3484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
64723
WV
363LP2300X
Primary Care Nurse Practitioner
APRN64723
WV
Other
Enumeration date
05/28/2015
Last updated
04/14/2026
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