MICHELLE LAKE

DAVENPORT, IA
NPI1033838826
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: IA  H171781)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IL  041439972)
163W00000X Registered Nurse
(Licence: IA  141908)
Enumeration Date2022-08-24
Last Update Date2023-07-13
Business Address
MICHELLE LAKE
1236 E RUSHOLME ST STE 300
DAVENPORT, IA 52803-2484
Phone number: 800-382-0707
Mailing Address
MICHELLE LAKE
11 WESTWOOD DR
GENESEO, IL 61254-9584
Phone number: 309-507-2367