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NPI Profile for DONALD LAKE in PORT HURON, MI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1871014944 |
|
| Status | Active | |
| Credentials | FNP-C (Family Nurse Practitioner, Certified) | |
| Entity | Individual | |
| Enumeration date | 06/29/2017 | |
| Last updated | 07/21/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DONALD LAKE
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DONALD LAKE, FNP-C