Dr MARY A LAKE NP is a female medical professional, specializing in Nurse Practitioner. She graduated in 2000.
EAST GRAND HEALTH CENTER INC
201 HOULTON RD
DANFORTH
ME
044243140
Tel: 2074482347
| Npi | 1578671871 |
| Pac Id | 1850305467 |
| Professional Enrollment Id | I20060203000091 |
| Last Name | LAKE |
| First Name | MARY |
| Middle Name | A |
| Suffix | |
| Gender | F |
| Credential | NP |
| Medical School Name | OTHER |
| Graduation Year | 2000 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | EAST GRAND HEALTH CENTER INC |
| Group Practice Pac Id | 4284642950 |
| Number Of Group Practice Members | 3 |
| Line 1 Street Address | 201 HOULTON RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | DANFORTH |
| State | ME |
| Zip Code | 044243140 |
| Phone Number | 2074482347 |
| Hospital Affiliation Ccn 1 | 201308 |
| Hospital Affiliation Lbn 1 | HOULTON REGIONAL HOSPITAL |
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| Professional Accepts Medicare Assignment | Y |
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