Individual provider · Type 1 NPI
Jerice Lake
Pediatric Nurse Practitioner · Mesa, AZ
NPI number
1154878072
Active
Practice location
2343 W Main St, Apt. 2030
Mesa, AZ 85201-9003
Mailing address
400 N Coronado St Apt 3010
Chandler, AZ 85224-3207
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN198973 (AZ) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 264646 (AZ) |
Pediatric Nurse Practitioner: Definition to come...
2 other providers at this address
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- Loriann Rochelle Lang, CPNPPediatric Nurse Practitioner Mesa, AZ NPI 1184164808
- Courtney Octave Howell, PNPPediatric Nurse Practitioner Mesa, AZ NPI 1225161763
- Angela J. Cabrera, CRNP (PNP-PC)Pediatric Nurse Practitioner Mesa, AZ NPI 1245375955
- Lindsey Nicole Weak, C-PNPPediatric Nurse Practitioner Mesa, AZ NPI 1326472150
- Rachel Nicole Welchans, CPNPPediatric Nurse Practitioner Mesa, AZ NPI 1336710615
About NPI 1154878072
Jerice Lake's National Provider Identifier is 1154878072, issued on Sep 8, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Mesa, AZ. The record was last updated on Feb 28, 2022.