Laura Lake, CRNP is a
Family Medicine based in Reform, Alabama. Laura Lake is licensed to practice in Alabama (license number 1191389) and her current practice location is
108 4th Ave Sw Ste A, Reform, Alabama. She can be reached at her office (for appointments etc.) via phone at
(205) 375-6251.
NPI number for Laura Lake is 1447179692 and her current mailing address is 108 4th Ave Sw Ste A, Reform, Alabama. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1447179692.
Provider's Profile
| Full Name | Laura Lake |
|---|
| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 108 4th Ave Sw Ste A, Reform, Alabama |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1447179692
- Provider Enumeration Date: 07/13/2026
- Last Update Date: 07/13/2026
Medical Identifiers
Medical identifiers for Laura Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1447179692 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LP2300X | Nurse Practitioner - Primary Care | 1191389 (Alabama) | Secondary |
| 207Q00000X | Family Medicine | 1191389 (Alabama) | 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. Laura 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 |
Laura Lake, CRNP 108 4th Ave Sw Ste A, Reform, AL 35481-8018 Ph: (205) 375-6251 | Laura Lake, CRNP 108 4th Ave Sw Ste A, Reform, AL 35481-8018 Ph: (205) 375-6251 |
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