Individual
BROOKE A LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
809 N STONE ST, DELAND, FL 32720-3255
(386) 734-1824
(386) 738-7497
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(386) 734-1824
(386) 738-7497
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN9233489
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN9233489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120553400
—
FL
Enumeration date
03/11/2015
Last updated
05/21/2024
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