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Abigail Diane Lake, DNP,PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner in Rockford, Illinois
NPI 1730669409

Abigail Diane Lake is a Psychiatric/Mental Health Nurse Practitioner based in Rockford, IL and is specialized in Psychiatric/Mental Health. Abigail Diane Lake practices in Rockford, IL and has the professional credentials of DNP,PMHNP-BC. The NPI Number for Abigail Diane Lake is 1730669409 and holds a License No. 041404632 (Illinois).

The current practice location address for Abigail Diane Lake is 8616 Northern Ave, Rockford, IL and can be reached out via phone at 815-399-9700 and via fax at 815-394-1401.

Location: 8616 Northern Ave, Rockford, IL, 61107-3877
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Provider Profile Details
NPI Number
1730669409
Provider Name
Abigail Diane Lake
Credential
DNP,PMHNP-BC
Provider Entity Type
Individual
Gender
Female
Address
8616 Northern Ave, Rockford, IL, 61107-3877
Phone Number
815-399-9700
Fax Number
815-394-1401
Provider Enumeration Date
08/21/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8616 Northern Ave
City
State
Zip
61107-5309
Phone Number
815-399-9700
Fax Number
815-394-1401
person
Provider Business Mailing Address Details
Address
8616 Northern Ave
City
State
Zip
61107-5309
Phone Number
815-399-9700
Fax Number
815-394-1401
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
209.028520 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
041404632 (Illinois)
Definition
Definition to come...
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