| Lake Clinic | |
|
311 W Lake St Minneapolis MN 55408-3026 | |
| (952) 210-7996 | |
| Not Available |
| Full Name | Lake Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 311 W Lake St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Jacquelyn Lee Denardo (OWNER) |
| Authorized Official Contact | 9522107996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Clinic 311 W Lake St Minneapolis MN 55408-3026 Ph: (952) 210-7996 | Lake Clinic 311 W Lake St Minneapolis MN 55408-3026 Ph: (952) 210-7996 |
| NPI Number | 1982065983 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 06/05/2025 |
| Certification Date | 06/05/2025 |
| Medicare PECOS PAC ID | 3375842115 |
|---|---|
| Medicare Enrollment ID | O20160429001268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982065983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Jacquelyn L Denardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598107237 PECOS PAC ID: 7911141767 Enrollment ID: I20130917000234 |
| Provider Name | Ayan a Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962808857 PECOS PAC ID: 2163724766 Enrollment ID: I20160113000528 |
Morningstar Wellness Center, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Washington Ave N, Suite 202, Minneapolis, MN 55401 Phone: 612-455-2920 Fax: 612-455-2921 |
Healthpartners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8170 33rd Ave S, Ms 21110q, Minneapolis, MN 55425 Phone: 952-883-7469 Fax: 952-883-5395 |
Boynton Health Service Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Church St Se, Minneapolis, MN 55455 Phone: 612-625-8400 Fax: 612-677-3211 |
Corban Health Care, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5141 36th Ave S, Minneapolis, MN 55417 Phone: 612-644-9047 |
Zaya Healthcare PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Seond Ave Suite 200 1631, Minneapolis, MN 55401 Phone: 612-300-2221 |
M Health Fairview Masonic Institute for the Developing Brain Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2025 E River Pkwy, Minneapolis, MN 55414 Phone: 612-301-0115 |