Provider Demographics
NPI:1952034068
Name:LAKES, DIANA L (RN CDCES)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:LAKES
Suffix:
Gender:F
Credentials:RN CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 LEESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8702
Mailing Address - Country:US
Mailing Address - Phone:859-255-6812
Mailing Address - Fax:859-253-5514
Practice Address - Street 1:3301 LEESTOWN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-8702
Practice Address - Country:US
Practice Address - Phone:859-255-6812
Practice Address - Fax:859-253-5514
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1088997163WP2201X, 163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care