DENISE LACK N.P.
NPI 1104839414
Nurse Practitioner in Jackson, CA

Q: What is Denise Lack's NPI number?

The NPI number for Denise Lack is 1104839414. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Q: What is Denise Lack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Denise Lack was last updated on July 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 15, 2006

100 MISSION BLVD, SUITE 2600, JACKSON, CA 95642(209) 257-1722(209) 257-1726 Get Directions Write a Review

NPPES record last updated: July 10, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Denise Lack N.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DENISE LACK N.P. (NPI 1104839414) is an individual nurse practitioner in Jackson, California, licensed in California (RN392072) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1104839414

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameDENISE LACKCredential: N.P.

Location Address100 MISSION BLVD, SUITE 2600Jackson, CA 95642-2536

Mailing Address10470 Old Placerville Rd, Suite 100Sacramento, CA 95827-2539 · (855) 771-0335

Phone(209) 257-1722

Fax(209) 257-1726

Sole ProprietorNo

Enumeration DateAugust 15, 2006

Last NPPES UpdateJuly 10, 2015

✔ NPI 1104839414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · RN392072

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

100 MISSION BLVD, Jackson, CA 95642

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Other Identifiers 2

Medicare PINCX763YCA

Medicare PINCX763ZCA

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APRIL MICHELLE BOITANO C.N.M, W.H.N.P

Advanced Practice Midwife

100 MISSION BLVD, SUITE 2800
JACKSON, CA 95642

Amador County (209) 257-0177

DR. AMY A. APPLETON M.D.

Pediatrics

100 MISSION BLVD, SUITE 2600
JACKSON, CA 95642

Amador County (209) 257-1722

SUTTER VALLEY HOSPITALS

Clinical Medical Laboratory

100 MISSION BLVD
JACKSON, CA 95642

Amador County (209) 223-7540

DR. AYE MYAT MOE M.D.

Pediatrics

100 MISSION BLVD, SUITE 2600
JACKSON, CA 95642

Amador County (209) 257-1725

COURTNEY PARKER PA-C

Physician Assistant

100 MISSION BLVD
JACKSON, CA 95642

Amador County (209) 257-7615

DR. VIKRAM RAMKUMAR KUMAR M.D.

Pediatrics

100 MISSION BLVD, SUITE 2600
JACKSON, CA 95642

Amador County (209) 257-1722

MAUREEN PATRICIA MOONEY-MICHELS R.D., C.D.E.

Dietitian, Registered

100 MISSION BLVD, OUTPATIENT DIABETES EDUCATION PROGRAM
JACKSON, CA 95642

Amador County (209) 223-7448

RACHEL ALAYNE WILLIAMS

Pediatrics

100 MISSION BLVD
JACKSON, CA 95642

Amador County (209) 257-1722

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Denise Lack's NPI number?

The NPI number for Denise Lack is 1104839414. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Where is Denise Lack located?

Denise Lack practices at 100 Mission Blvd Suite 2600, Jackson, CA 95642. The listed phone number is (209) 257-1722.

What is Denise Lack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Denise Lack was last updated on July 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.