KATELYN MARIE LAKE

SOUTH BEND, IN
NPI1811631898
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IN  138174)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IN  28229724A)
Enumeration Date2022-04-25
Last Update Date2023-05-08
Business Address
Dr. KATELYN MARIE LAKE CRNA
615 N MICHIGAN ST
SOUTH BEND, IN 46601-1087
Phone number: 574-647-1000
Mailing Address
Dr. KATELYN MARIE LAKE CRNA
50778 STURDY OAK CT
GRANGER, IN 46530-6727
Phone number: 219-405-7898