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Individual
LACEY RENEE MERSINO
Active
Individual
LACEY RENEE MERSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704279003
MI
363LP0200X
Pediatric Nurse Practitioner
36200
TN
363LP0200X
Pediatric Nurse Practitioner
4704279003
MI
Other
Enumeration date
03/05/2015
Last updated
03/11/2025
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