Individual
LACY PITCHFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1263 W ROSEDALE ST STE 200, FORT WORTH, TX 76104-2837
(817) 336-4896
(817) 332-2805
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
684218
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP125452
TX
Other
Enumeration date
04/10/2014
Last updated
05/08/2024
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