Individual
LACEY LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
75 W RED BANK AVE, WOODBURY, NJ 08096-1694
(856) 451-4700
Mailing address
17 BURNETT AVE, MAYS LANDING, NJ 08330-4212
(727) 460-7746
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15145700
NJ
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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