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Individual
LACEY GENTRY
Active
Individual
LACEY GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM291392
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
291392
GA
176B00000X
Midwife
Primary
291392
GA
367A00000X
Advanced Practice Midwife
Primary
RN291392
GA
Other
Enumeration date
06/12/2024
Last updated
07/23/2026
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