ALICIA LARAE LAKE

HANNIBAL, MO
NPI1891449625
Former NameALICIA LARAE LEWELLEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MO  2021023511)
Enumeration Date2022-02-10
Last Update Date2022-02-10
Business Address
ALICIA LARAE LAKE MSN, NP-C
6500 HOSPITAL DR
HANNIBAL, MO 63401-6890
Phone number: 573-629-3300
Mailing Address
ALICIA LARAE LAKE MSN, NP-C
PO BOX 1239
HANNIBAL, MO 63401-1239
Phone number: 573-406-5888
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