JENNIFER A LAKE (NPI# 1245205301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245205301 |
| Entity Type | Individual |
| Full Name | JENNIFER A LAKE |
| Credential | MD |
| Practice Address |
4422 White Bear Ave N White Bear Lake MN 55110-3475 |
| Practice Telephone | 6512878780 |
| Practice Fax Number | 6512878786 |
| Mailing Telephone | 6512878780 |
| Mailing Fax Number | 6512878786 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2015-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 44657 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 179001300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467799940 | Jennifer Lake | Massage Therapist | 5211 Highway 153 Ste D, Hixson, TN 37343-4957 | 2013-01-03 |
| 1801199302 | Jennifer Marie Lake | Marriage & Family Therapist | 2233 N. Hamline Ave., Suite 411, Roseville, MN 55113 | 2010-12-06 |
| 1760006506 | Jennifer L Lake | Case Manager/Care Coordinator | 4298 Great Egret Way, Middleburg, FL 32068-8760 | 2020-06-07 |
| 1669007597 | Jennifer Lake | Physical Medicine & Rehabilitation | 112 Harcourt Rd, Mount Vernon, OH 43050-3946 | 2020-03-11 |
| 1164079968 | Jennifer Lake | Counselor | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-08-26 |
| 1679090187 | Jennifer Diane Lake | Nurse Practitioner | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2017-08-25 |
| 1922461441 | Jennifer Lake | Nurse Practitioner | 3500 Maple Ave, Terre Haute, IN 47804-1732 | 2016-04-01 |
| 1285073924 | Jennifer Marie Lake | Registered Nurse | 3333 36th St Se, Grand Rapids, MI 49512-2809 | 2013-06-16 |
| 1881821239 | Jennifer R. Lake | Advanced Practice Midwife | 12605 E 16th Ave, University of Colorado, Aurora, CO 80045-2545 | 2009-06-12 |
| 1740436617 | Jennifer Belle Lake | Counselor | 1333 Iris Ave, Boulder, CO 80304-2226 | 2008-08-12 |
| Street Address |
4422 WHITE BEAR AVE N |
| City | WHITE BEAR LAKE |
| State | MN |
| Zip Code | 55110-3475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275933715 | Lea Wetzell | Nutritionist | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2014-09-03 |
| 1437496890 | Emily Ann Ceci | Chiropractor | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2013-01-05 |
| 1992049365 | In-tune Wellness LLC | Dietitian, Registered | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2012-11-25 |
| 1538468293 | Integrated Chiropractic Services | Chiropractor | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2011-03-21 |
| 1548575434 | Synergy Family Physicians, P.a. | Internal Medicine | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2010-08-16 |
| 1255660981 | Serenity Now Healing Center, LLC | Massage Therapist | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2009-12-08 |
| 1417195363 | Sara Lynn Ruiz | Dietitian, Registered | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2009-01-30 |
| 1962690354 | Nancy Kay Sheely Weirens | Acupuncturist | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2007-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
| 1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
| 1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
| 1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
| 1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
| 1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
| 1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
| Find all providers in zip 55110 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349280 | Anna Dalrymple | Family Medicine | 3832 Mcknight Rd N, White Bear Lake, MN 55110-4874 | 2020-09-07 |
| 1477797264 | Patrick Thomas Dornack | Family Medicine | 2555 County Road E E, White Bear Lake, MN 55110-4906 | 2009-04-24 |
| 1700897881 | John P Hamerly | Family Medicine | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2006-08-11 |
| 1831141886 | Ann M Barry | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110 | 2006-05-17 |
| 1720030083 | Teresa A Pena | Family Medicine | 4525 White Bear Pkwy, Suite 130, White Bear Lake, MN 55110-7651 | 2006-05-16 |
| 1992772354 | Danielle R Perry | Family Medicine | 4422 White Bear Ave, White Bear Lake, MN 55110 | 2006-03-03 |
| 1437150877 | Aalfa Family Practice Pa | Family Medicine | 4465 White Bear Pkwy, White Bear Lake, MN 55110-7626 | 2005-08-09 |
| 1699126169 | Tou Lee Xiong | Family Medicine | 1430 Highway 96 E, White Bear Lake, MN 55110-3653 | 2016-06-27 |
| 1669882791 | Jenna Keller | Family Medicine | 1430 Highway 96 E, White Bear Lake, MN 55110-3653 | 2014-04-28 |
| 1922441278 | Russell Spingarn | Family Medicine | 1430 Highway 96 E, White Bear Lake, MN 55110-3653 | 2013-04-16 |
| Find all providers in WHITE BEAR LAKE | ||||
| City | WHITE BEAR LAKE |
| Zip Code | 55110 |
Please comment or provide details below to improve the information on JENNIFER A LAKE.
| 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.