Andrew Lake, LPN in Columbia Heights, MN - Licensed Practical Nurse

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.

Contact Information

	Andrew Lake, LPN
	4129 5th St Ne, Columbia Heights, MN 55421-2859
	(763) 781-5804
	Not Available

Provider's Profile

Full Name	Andrew Lake
Gender	Male
Speciality	Licensed Practical Nurse
Location	4129 5th St Ne, Columbia Heights, Minnesota
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

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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Andrew Lake, LPN - Licensed Practical Nurse in Columbia Heights, MN