Lake, Jerice

Lake, Jerice is an sole proprietor health care provider with primary practice located at 2343 W Main St Apt. 2030, Mesa AZ 85201-9003. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Lake, Jerice can be contacted via phone (340) 642-4597.

Contact Information

Primary practice address
2343 W Main St Apt. 2030 Mesa AZ 85201-9003
Phone: (340) 642-4597
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN198973 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 264646 Arizona

Profile Details

NPI number 1154878072
LBN Legal business name Lake, Jerice
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2016
Last updated Feb 28th, 2022 - about 4 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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