DOROTHY NICOLE LAKE

CARROLLTON, GA
NPI1528438538
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: GA  RN213402NP)
Enumeration Date2015-10-02
Last Update Date2015-10-02
Business Address
-- DOROTHY NICOLE LAKE CPNP
1561 S HIGHWAY 27 UNIT B6 & B7
CARROLLTON, GA 30117-8927
Phone number: 404-366-3636
Mailing Address
-- DOROTHY NICOLE LAKE CPNP
4905 COURTNEY DR
FOREST PARK, GA 30297-1427
Phone number: 404-366-3636
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