Jerice Lake
NPI 1154878072 · Pediatric Nurse Practitioner · Mesa, AZ
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jerice Lake is a Pediatric Nurse Practitioner provider in Mesa, AZ (NPI 1154878072).
Provider details
- NPI number
- 1154878072
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- RN198973 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-09-08
- Last updated
- 2022-02-28
- Certified
- 2022-02-28
Frequently asked questions
- What is Jerice Lake's NPI number?
- Jerice Lake's National Provider Identifier (NPI) is 1154878072, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jerice Lake's specialty?
- Jerice Lake is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jerice Lake located?
- Jerice Lake's practice location on file with NPPES is 2343 W Main St, Mesa, AZ 85201-9003.
- What is Jerice Lake's phone number?
- The practice phone number listed in the NPPES registry for Jerice Lake is (340) 642-4597.
- Does Jerice Lake accept Medicare?
- Jerice Lake is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jerice Lake's NPI active?
- Yes — Jerice Lake's NPI (1154878072) is active in the NPPES registry as of the last update on 2022-02-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.