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Provider Information for 1922267467

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MRS. JOLEEN M LAKE A.P.R.N.

Gender: FEMALE

Individual NPI: 1922267467

Calendar   Last Updated:  2015-06-04
  Certification Date: 

Details

Name Value
NPI 1922267467
Enumeration Date 2008-06-09
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2608 S 158TH PLZ
OMAHA, NE 68130-1704
United States

Phone: 402-578-5353 | Fax: 402-715-5040
View Map External Link
Primary Practice Address 2608 S 158TH PLZ
OMAHA, NE 68130-1704
United States

Phone: 402-578-5353 | Fax: 402-715-5040
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LF0000X - Nurse Practitioner Family NE 110939