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General NPI Number Information
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NPI Number | 1235421165
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Entity Type | Individual
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Provider Name | CLAIRE MARIE LAKES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1332 N FERDON BLVD
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City | CRESTVIEW
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State | FL
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Zip | 32536-1749
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Country | US
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Telephone | 850-346-1936
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Fax | 557-413-0808
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Provider Business Mailing Address
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Address Line | 1005 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6707
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Country | US
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Telephone | 850-863-8219
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Fax | 850-863-8249
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9213390
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License Number State | FL
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