Jennifer A Lake, MD

NPI #1245205301 in White Bear Lake, Minnesota

Provider Information

NPI Number: 1245205301
Entity Type: Individual
Name: Jennifer A Lake, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Feb 22, 2006
Last Updated: Dec 8, 2015

Practice Location

Address: 4422 WHITE BEAR AVE N
City: White Bear Lake
State: Minnesota
ZIP Code: 55110-3475
Phone: (651) 287-8780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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