Individual
LACI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
707 CANDY CANE LN, ELLAVILLE, GA 31806-2639
(229) 938-9234
Mailing address
707 CANDY CANE LN, ELLAVILLE, GA 31806-2639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN248397
GA
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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