DOROTHY NICOLE LAKE (NPI# 1528438538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528438538 |
| Entity Type | Individual |
| Full Name | DOROTHY NICOLE LAKE |
| Credential | CPNP |
| Practice Address |
1561 S Highway 27 Unit B6 & B7 Carrollton GA 30117-8927 |
| Mailing Address |
4905 Courtney Dr Forest Park GA 30297-1427 |
| Practice Telephone | 4043663636 |
| Practice Fax Number | 4043620808 |
| Mailing Telephone | 4043663636 |
| Mailing Fax Number | 4043620808 |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN213402NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1561 S HIGHWAY 27 UNIT B6 & B7 |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-8927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205444692 | Tamrah Moore | Nurse Practitioner | 4609 Cherokee Path, Carrollton, TX 75010-2073 | 2020-07-21 |
| 1326404393 | Miaojuan Li | Nurse Practitioner | 4100 Fairway Dr Ste 300, Carrollton, TX 75010 | 2016-01-06 |
| 1265786271 | Suji Ann John | Nurse Practitioner | 3828 Menard Dr, Carrollton, TX 75010-6470 | 2012-10-30 |
| 1730557869 | Lyndi Nicole Bowling | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117 | 2015-09-06 |
| 1346631322 | Elisabeth Mcpherson | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2015-02-11 |
| 1679977003 | Katherine Newton | Nurse Practitioner | 2459 E Hebron Pkwy, Carrollton, TX 75010-4482 | 2014-10-14 |
| 1255521647 | Keatrina T Springer | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2007-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565811 | Rebecca Danielle Wegman | Nurse Practitioner | 5445 Meridian Mark Rd Ste 380, Atlanta, GA 30342-4755 | 2020-10-09 |
| 1629675657 | Casey Cullins | Nurse Practitioner | 980 Johnson Fy Rd Ne Ste 680, Atlanta, GA 30342-1608 | 2020-10-02 |
| 1336755289 | Taylor Bishop | Nurse Practitioner | 51 Hidden Lake Ct, Savannah, GA 31419-1664 | 2020-09-16 |
| 1942815717 | Valerie Renee' Grenald | Nurse Practitioner | Augusta University Health, Augusta, GA 30912-0001 | 2020-09-09 |
| 1538798095 | Brittany Nicole Heitkamp | Nurse Practitioner | 5461 Meridian Mark Rd Ste 540, Atlanta, GA 30342-3283 | 2020-04-06 |
| 1629606421 | Anna Elizabeth Patton | Nurse Practitioner | 12 Sammy Mcghee Blvd Ste 102, Jasper, GA 30143-7712 | 2020-03-29 |
| 1093342131 | Lindsay Pare | Nurse Practitioner | 2225 Twin Lakes Dr, Atlanta, GA 30339-4123 | 2020-03-26 |
| 1215564976 | Stephanie Laurel Toole | Nurse Practitioner | 625 Big Shanty Rd Nw, Kennesaw, GA 30144-3646 | 2020-03-24 |
| 1740816487 | Aleksa Rozman | Nurse Practitioner | 1121 Johnson Ferry Rd Ste 220, Marietta, GA 30068-2763 | 2020-03-13 |
| 1912530866 | Rebecca L Brigola | Nurse Practitioner | 4120 Five Forks Trickum Rd Sw Ste 102, Lilburn, GA 30047-8975 | 2020-02-19 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on DOROTHY NICOLE 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.