Individual
DOROTHY NICOLE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
706 DIXIE ST STE 200, CARROLLTON, GA 30117-3889
(770) 812-8640
(770) 838-8650
Mailing address
706 DIXIE ST STE 220, CARROLLTON, GA 30117-3889
(770) 812-8825
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN-NP213402
GA
Other
Enumeration date
10/02/2015
Last updated
10/24/2025
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