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

Mrs. Leslie Ann Lake, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1134877525

Mrs. Leslie Ann Lake, FNP-BC is a Nurse Practitioner in Berlin, Maryland. Qualified in 2021, 5 years ago. Practices with University of Maryland Community Medical Group Inc, a 450-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
5
Licensed in
MD
In the registry since
2022
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

9858 Shore Break Ln Apt 311
Berlin, MD 21811-3028
Phone: (912) 689-9322
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R155906 (MD)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R155906 (MD)

Record details

NPI number1134877525
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedMarch 15, 2022
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice University Of Maryland Community Medical Group Inc — 450 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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