Andrew Lake, LPN is a
Licensed Practical Nurse based in Columbia Heights, Minnesota. Andrew Lake is licensed to practice in Minnesota (license number 791526) and his current practice location is
4129 5th St Ne, Columbia Heights, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(763) 781-5804.
NPI number for Andrew Lake is 1053905471 and his current mailing address is 4129 5th St Ne, Columbia Heights, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053905471.
Provider's Profile
| Full Name | Andrew Lake |
|---|
| Gender | Male |
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| Speciality | Licensed Practical Nurse |
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| Location | 4129 5th St Ne, Columbia Heights, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1053905471
- Provider Enumeration Date: 02/25/2021
- Last Update Date: 02/25/2021
Medical Identifiers
Medical identifiers for Andrew Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053905471 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 791526 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrew Lake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Andrew Lake, LPN
4129 5th St Ne,
Columbia Heights, MN 55421-2859
Ph: (763) 781-5804 | Andrew Lake, LPN
4129 5th St Ne,
Columbia Heights, MN 55421-2859
Ph: (763) 781-5804 |
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