Provider Demographics
NPI:1871474999
Name:LAKE, LAUREN BROOKS (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BROOKS
Last Name:LAKE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 CRANSWICK CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-8107
Mailing Address - Country:US
Mailing Address - Phone:703-447-6392
Mailing Address - Fax:
Practice Address - Street 1:8640 SUDLEY RD STE 203
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4404
Practice Address - Country:US
Practice Address - Phone:703-368-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024194508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily