NPI | 1396200481 |
---|---|
Former Name | LYDIA M LAKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 024164) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704417089) |
363L00000X Nurse Practitioner (Licence: KY 3013706) | |
363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.024164) | |
Enumeration Date | 2019-02-04 |
Last Update Date | 2025-05-28 |