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Individual
MELANIE ANN LACY
Active
Individual
MELANIE ANN LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
18680
SC
363L00000X
Nurse Practitioner
Primary
RN191439
GA
363LP0222X
Critical Care Pediatric Nurse Practitioner
AP127143
TX
Other
Enumeration date
02/20/2014
Last updated
07/09/2021
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