Stephanie M Lake-Melton, PA-C

NPI #1104113141 in Beloit, Wisconsin

Provider Information

NPI Number: 1104113141
Entity Type: Individual
Name: Stephanie M Lake-Melton, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 28, 2011
Last Updated: Oct 3, 2022

Practice Location

Address: 74 ECLIPSE CTR
City: Beloit
State: Wisconsin
ZIP Code: 53511-3550
Phone: (608) 361-0331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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