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Individual
MRS. CONSTANCE SUE LACKNER
Active
Individual
MRS. CONSTANCE SUE LACKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN APRN BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024182053
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7278
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3143910
BLUE CROSS BLUE SHIELD
TN
05
—
3345085
—
TN
01
—
890000552
RAILROAD PROVIDER
—
Enumeration date
03/24/2006
Last updated
11/06/2024
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