Lake, Abigail Diane

Lake, Abigail Diane is an individual health care provider with primary practice located at 8616 Northern Ave , Rockford IL 61107-5309. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Addiction (Substance Use Disorder), Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Lake, Abigail Diane can be contacted via phone (815) 399-9700.

Contact Information

Primary practice address
8616 Northern Ave Rockford IL 61107-5309
Phone: (815) 399-9700
Fax: (815) 394-1401
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 041404632 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 209.028520 Illinois

Profile Details

NPI number 1730669409
LBN Legal business name Lake, Abigail Diane
Credentials DNP, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2018
Last updated Oct 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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