Individual provider · Type 1 NPI

Dorothy Nicole Lake, CPNP

Pediatric Nurse Practitioner · Carrollton, GA

NPI number 1528438538 Active

Practice location

706 Dixie St Ste 200
Carrollton, GA 30117-3889

Fax (770) 838-8650

Mailing address

706 Dixie St Ste 220
Carrollton, GA 30117-3889

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XAPRN-NP213402 (GA)

Pediatric Nurse Practitioner: Definition to come...

7 other providers at this address

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About NPI 1528438538

Dorothy Nicole Lake, CPNP's National Provider Identifier is 1528438538, issued on Oct 2, 2015. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Carrollton, GA. The record was last updated on Oct 24, 2025.