Lake, Leslie Ann
Lake, Leslie Ann is an sole proprietor health care provider with primary practice located at 9858 Shore Break Ln Apt 311 , Berlin MD 21811-3028. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lake, Leslie Ann can be contacted via phone (912) 689-9322.Contact Information
Primary practice address
9858 Shore Break Ln Apt 311
Berlin MD 21811-3028
Phone: (912) 689-9322
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R155906 | Maryland |
Profile Details
| NPI number | 1134877525 |
|---|---|
| LBN Legal business name | Lake, Leslie Ann |
| Credentials | FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 15th, 2022 |
| Last updated | Mar 15th, 2022 - about 2 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 | 1134877525 | NPPES |
| Maryland | Other | R155906 | LICENSURE |
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