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1891028346
CAROL LAKE
BALTIMORE, MD
NPI
1891028346
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Former Name
CAROL WILKES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MD R101279)
Enumeration Date
2009-09-16
Last Update Date
2012-10-05
Business Address
Ms. CAROL LAKE FNP
430 S BROADWAY
BALTIMORE, MD 21231-2409
Phone number: 443-825-3450
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Mailing Address
Ms. CAROL LAKE FNP
430 S BROADWAY
BALTIMORE, MD 21231-2409
Phone number: 443-825-3450
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