Individual
MARY ALMA LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 WELLNESS WAY, SUITE B, TOPSHAM, ME 04086-1768
(207) 406-7667
(207) 406-7601
Mailing address
1 WELLNESS WAY, SUITE B, TOPSHAM, ME 04086-1768
(207) 406-7667
(207) 406-7601
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
R019912
ME
363LF0000X
Family Nurse Practitioner
Primary
R019912
ME
Other
Enumeration date
08/27/2006
Last updated
02/11/2016
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