Provider Demographics
NPI:1841858115
Name:LAKES, KATELYN JEAN (MSN, RN, CNL, FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:JEAN
Last Name:LAKES
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Gender:F
Credentials:MSN, RN, CNL, FNP-C
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Mailing Address - Street 1:1100 SOUTHFIELD DR STE 1370
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4300
Mailing Address - Country:US
Mailing Address - Phone:317-837-5570
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:112 HOSPITAL LN STE 301
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1998
Practice Address - Country:US
Practice Address - Phone:317-718-9028
Practice Address - Fax:317-386-5468
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2021-03-19
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Provider Licenses
StateLicense IDTaxonomies
IN28229474A163W00000X
IN71009099A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse