Lacey Darlene Lake Foreman, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

13651 Issued in MN

Practice address

820 Lilac Dr N Ste 210
Golden Valley, MN 55422-4754

Phone

(763) 205-3600

NPI assigned

Nov 3, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Lacey Darlene Lake Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Ars Treatment Centers PCGroup PAC ID 0042568131, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ars Treatment Centers, P.C.

  • Multi-Specialty Clinic/Center
  • Uniontown, PA
  • NPI 1346731171
  Medicare reassignment Care Compare group NPD
• Ars Treatment Centers, P.C.

  • Clinical Medical Laboratory
  • Beaver, PA
  • NPI 1992370324
  NPD
• Moments Hospice of Eau Claire LLC

  • Community Based Hospice Care Agency
  • Eau Claire, WI
  • NPI 1194375915
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1922510635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2843 STATE ROUTE 31",
            "city": "ACME",
            "state": "PA",
            "postal_code": "156101371",
            "telephone_number": "724-875-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N STE 210",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224754",
            "telephone_number": "763-205-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2263 Eastridge Ctr",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547013410",
            "country_code": "US",
            "telephone_number": "715-800-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE FOREMAN",
        "first_name": "LACEY",
        "middle_name": "DARLENE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-03",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "17742-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018060",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "13651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "LAKE",
            "middle_name": "DARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheyam Ladwa, PHARMD, APH, BCACP
• Daniel Lawrence Lafontaine, PT
• Nicole L Lainhart, MS CCC SLP
• Justin Lajoie, LPCC
• Jutone Lajoie, LICSW
• Lakeview Transportation
• Theresa Stepan Land, LICSW
• Rebecca Ann Lange, MA, OTR/L
• Laura E Langemak, PHARMD
• Language Link Interpreting

• Nurse Practitioner in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.