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Contact Information

LAKES DERMATOLOGY, PLLC
2704 ENTERPRISE AVE
SPIRIT LAKE, IA51360
 Phone: 712-336-2728
 Fax: 712-336-2842
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LAKES DERMATOLOGY PLLC · (Female)

NPI # 1194186833
Status Active
Credentials
Entity Individual
Enumeration date 03/08/2016
Last updated 12/21/2022 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • IA License # A-118055
  • IA Other 1841548161 INDIVIDUAL NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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