Individual
LACEE WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604
(801) 374-9625
(801) 374-9690
Mailing address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6695
(801) 374-9625
(801) 374-9690
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA52245
CA
363AS0400X
Surgical Physician Assistant
Primary
8139778-1206
UT
363AS0400X
Surgical Physician Assistant
PA52245
CA
Other
Enumeration date
11/10/2011
Last updated
03/13/2026
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