Individual
LACEY GOBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1029 W MAIN ST STE M, LEBANON, TN 37087-3347
(615) 453-1252
Mailing address
274 HUTCH CT, GALLATIN, TN 37066-1575
(615) 627-8459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000237578
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
3-001079
AL
Other
Enumeration date
04/05/2021
Last updated
07/10/2023
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