Lake, Linda

Lake, Linda is an individual health care provider with primary practice located at 3026 Brisbane Dr , Mount Juliet TN 37122-8500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Lake, Linda can be contacted via phone (615) 754-7658.

Contact Information

Primary practice address
3026 Brisbane Dr Mount Juliet TN 37122-8500
Phone: (615) 754-7658
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 020316 Tennessee

Profile Details

NPI number 1457352320
LBN Legal business name Lake, Linda
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457352320 NPPES
Tennessee MEDICAID 3633942
Tennessee MEDICAID 74008814

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