IndividualActive
Abigail Lake, DNP, PMHNP-BC
NPI 1730669409 · Psychiatric/Mental Health Nurse Practitioner · Rockford, IL
Provider details
- NPI number
- 1730669409
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- DNP, PMHNP-BC
- Sex
- Female
- Sole proprietor
- No
- License
- 041404632 (IL)
Practice location
8616 Northern Ave
Rockford, IL 61107-5309
Phone: (815) 399-9700
Fax: (815) 394-1401
Mailing address
1021 N Mulford Rd
Rockford, IL 61107-3877
Registry dates
- Enumerated
- 2018-08-21
- Last updated
- 2023-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.