LACEY JO LAKE (NPI# 1043624083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043624083 |
| Entity Type | Individual |
| Full Name | LACEY JO LAKE |
| Other Name | LACEY JO MCFADDEN |
| Practice Address |
2114 Pinefield St Muscatine IA 52761-2553 |
| Practice Telephone | 5636072372 |
| Mailing Telephone | 5636072372 |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | 11471 | IA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2114 PINEFIELD ST |
| City | MUSCATINE |
| State | IA |
| Zip Code | 52761-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282327 | Jaime S Jose Jr. | Physical Therapist | Lutheran Living Senior Campus, 2421 Lutheran Drive, Muscatine, IA 52761 | 2020-10-15 |
| 1871063446 | Stephanie Marie Fiser | Counselor | 503 Iowa Ave, Muscatine, IA 52761 | 2018-11-27 |
| 1194215269 | Iowa Physicians Clinic Medical Foundation | Clinic/Center | 3426 N Port Dr Ste 200, Muscatine, IA 52761 | 2018-05-15 |
| 1538614086 | Sejal Savani | Dentist | 3020 N Highway 61, Muscatine, IA 52761 | 2016-08-24 |
| 1932468006 | Jason R Carstens | Chiropractor | 3800 Grandview Avenue, Muscatine, IA 52761 | 2012-05-10 |
| 1699062166 | Joyce Esther Hart-leon | Marriage & Family Therapist | 2821 Hwy 22 East., Muscatine, IA 52761 | 2011-07-06 |
| 1750533667 | Sunnybrook of Muscatine | Assisted Living Facility | 3515 Dianna Queen Drive, Muscatine, IA 52761 | 2008-10-22 |
| 1346415403 | Marcie L. Nithang | Counselor | 315 Iowa Ave., Ste. C, Muscatine, IA 52761 | 2008-04-29 |
| 1023238474 | Barbara Joan Gipple | Dentist | 2195 North Hill Road, Muscatine, IA 52761 | 2007-04-26 |
| 1154484954 | Holly Ann Krystek | Dentist | 2920 Cedar St, Muscatine, IA 52761 | 2006-12-19 |
| Find all providers in zip 52761 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942741152 | Amy Ockenfels | Radiologic Technologist | 1360 Marak Rd Nw, Swisher, IA 52338-9575 | 2017-03-20 |
| 1255629499 | Jeffrey Micah Kreyling | Radiologic Technologist | 5108 Lower Beaver, Des Moines, IA 50310-4348 | 2011-07-20 |
| 1235313818 | Jennifer Lynn Jordt Roberts | Radiologic Technologist | 1777 108th St, Marengo, IA 52301-8726 | 2007-12-19 |
| 1528680071 | Sarah Sorsen | Radiologic Technologist | 1301 Summit St, Marshalltown, IA 50158-5484 | 2020-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.