Individual
MRS. LACEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, CRNP, PNP-PC
Contact information
Practice address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
(205) 638-9173
Mailing address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-131803
AL
363LP0200X
Pediatric Nurse Practitioner
Primary
1-131803
AL
Other
Enumeration date
01/27/2023
Last updated
12/13/2024
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