Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Lake

Individual provider Registered Nurse · NPI 1033838826

Michelle Lake is a Nurse Practitioner in Davenport, Iowa. Qualified in 2022, 4 years ago. Practices with Cardiovascular Medicine PLLC, a 50-clinician group and accepts Medicare assignment. Licensed in Iowa and Illinois.

Years since qualifying
4
Licensed in
IA, IL
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

1236 E Rusholme St Ste 300
Davenport, IA 52803-2484
Phone: (800) 382-0707
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence H171781 (IA)
Registered Nurse Taxonomy 163W00000X · Licence 041439972 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 141908 (IA)

Record details

NPI number1033838826
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 24, 2022
Last updated in NPPESJuly 13, 2023
Certification dateJuly 13, 2023
Mailing address11 Westwood Dr, Geneseo, IL 61254-9584

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cardiovascular Medicine Pllc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Davenport