Individual
DAVON LACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 WOODLANE DR, SEARCY, AR 72143-6113
(501) 268-3733
Mailing address
103 WOODLANE DR, SEARCY, AR 72143-6113
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A004220
AR
Other
Enumeration date
02/05/2015
Last updated
10/06/2021
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