Individual
LACEY WHATLEY VASILAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2770 3RD AVE STE 210, LAKE CHARLES, LA 70601-0404
(337) 494-6768
(337) 494-6792
Mailing address
PO BOX 122579 DEPT 2579, DALLAS, TX 75312-2579
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07810
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2369385
—
LA
01
—
AP07810
STATE LICENSE
LA
Enumeration date
07/19/2013
Last updated
04/28/2022
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