Lake, Jennifer A
Lake, Jennifer A is an individual health care provider with primary practice located at 4422 White Bear Ave N , White Bear Lake MN 55110-3475. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Lake, Jennifer A can be contacted via phone (651) 287-8780.Contact Information
Primary practice address
4422 White Bear Ave N
White Bear Lake MN 55110-3475
Phone: (651) 287-8780
Fax: (651) 287-8786
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 44657 | Minnesota |
Profile Details
| NPI number | 1245205301 |
|---|---|
| LBN Legal business name | Lake, Jennifer A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Dec 8th, 2015 - about 9 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245205301 | NPPES |
| Minnesota | MEDICAID | 179001300 |
Popular Providers
-
Steeber, Gregory D
1430 Hwy 96 E Mail Stop 32300A, White Bear Lake MN 55110-7693 -
Hamerly, John P
3220 Bellaire Ave , White Bear Lake MN 55110-5854 -
Kobbermann, Kathleen A
4465 White Bear Parkway , White Bear Lake MN 55110 -
Dornack, Patrick Thomas
2555 County Road E E , White Bear Lake MN 55110-4906 -
Vincent, Owen D
1430 Highway 96 E , White Bear Lake MN 55110-3653 -
Duthoy, Dale J
4786 Banning Ave , White Bear Lake MN 55110-3264 -
Micallef, Joseph Stephen
1430 Hwy 96 E - Mail Stop 32300A Healthpartners White Bear Lake Clinic, White Bear Lake MN 55110-7693 -
Pena, Teresa A
4525 White Bear Pkwy Suite 130, White Bear Lake MN 55110-7651