| Jennifer Marie Lake, PMHNP | |
|
1550 E Beltline Ave Se Ste 155, Grand Rapids, MI 49506-4362 | |
| (616) 466-2924 | |
| Not Available |
| Full Name | Jennifer Marie Lake |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 1550 E Beltline Ave Se Ste 155, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285073924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 4704248401 (Michigan) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 4704248401 (Michigan) | Primary |
| Entity Name | West Michigan Psychological Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215407044 PECOS PAC ID: 6103238167 Enrollment ID: O20201215003321 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Marie Lake, PMHNP 5638 Linedrive Ct Ne, Comstock Park, MI 49321-9626 Ph: (616) 540-1930 | Jennifer Marie Lake, PMHNP 1550 E Beltline Ave Se Ste 155, Grand Rapids, MI 49506-4362 Ph: (616) 466-2924 |
Paul Dieleman, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1131 Ionia Ave Nw, Grand Rapids, MI 49503 Phone: 616-259-7900 Fax: 616-259-7909 | |
Dr. Katherine E. Kunnen, DNP, FNP-C, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3300 36th St Se, Grand Rapids, MI 49512 Phone: 616-942-2110 Fax: 616-942-9548 | |
Vanessa Rae Smitko, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2770 E Beltline Ave Ne, Grand Rapids, MI 49525 Phone: 616-267-8860 | |
Khira Lauren Benson, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503 Phone: 616-267-9150 | |
Ms. Marissa Claire Niemeyer, MSN, AGPCNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 145 Michigan St Ne Ste 3410, Grand Rapids, MI 49503 Phone: 616-391-9945 | |
Cassandra Cummings, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503 Phone: 616-486-6790 | |
Anne Therese Beauchamp, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1055 Medical Park Dr Se, Grand Rapids, MI 49546 Phone: 616-942-9610 |