Individual provider · Type 1 NPI
Catherine Dettelbach Lake, FNP-C
Nurse Practitioner · Jacksonville, FL
Practice location
915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Fax (904) 486-2314
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | APRN11006998 (FL) |
| Nurse Practitioner Primary | 363L00000X | APRN11006998 (FL) |
| Adult Health Nurse Practitioner | 363LA2200X | APRN11006998 (FL) |
| Family Nurse Practitioner | 363LF0000X | APRN11006998 (FL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1265039424
Catherine Dettelbach Lake, FNP-C's National Provider Identifier is 1265039424, issued on Oct 1, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Jacksonville, FL. The record was last updated on Jan 21, 2025.