JERICE LAKE

Pediatric Nurse Practitioner

NPI: 1154878072IndividualAccepts Medicare

Specialties, Licenses & Credentials

Registered Nurse

Registered Nurse

Code: 163W00000X

RN198973(AZ)

Pediatric Nurse PractitionerPrimary

Nurse Practitioner — Pediatrics

Code: 363LP0200X

264646(AZ)

CMS Specialties

PrimaryNURSE PRACTITIONER

Education

OTHER

Class of 2021

Contact & Hours

Address: 2343 W MAIN ST, APT. 2030
MESA, AZ 85201
Phone: (340) 642-4597

Quick Facts

NPI: 1154878072
Entity Type: Individual
Gender: Female
Medicare: Accepted
Specialties: 2
Locations: 1
Years in Practice: 5

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