# LACEY JACKSON LANDON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1174922314
- **Gender:** F
- **Credential:** AA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367H00000X | Anesthesiologist Assistant | — | GA | Yes |

## Other

- **Enumeration date:** 08/13/2014
- **Last updated:** 08/13/2014