Individual
MISS KARI ANNE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1708A OWEN DR, FAYETTEVILLE, NC 28304-3419
(910) 307-7330
(910) 307-7334
Mailing address
1708A OWEN DR, FAYETTEVILLE, NC 28304-3419
(910) 307-7330
(910) 307-7334
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2011-01164
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011-01164
NORTH CAROLINA MEDICAL BOARD
NC
Enumeration date
04/21/2008
Last updated
05/02/2023
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