Individual
LACEY RAE FOX-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
30 ASSEMBLY DR STE 101, MENDON, NY 14506-9608
(585) 624-4520
Mailing address
30 ASSEMBLY DR STE 101, MENDON, NY 14506-9608
(585) 624-4520
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
630457
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382380
NY
Other
Enumeration date
08/12/2011
Last updated
08/24/2022
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