Individual
MRS. LACEY ANGELLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, NNP-BC
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 470-5634
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 470-5634
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
RN119251
LA
363LN0000X
Neonatal Nurse Practitioner
Primary
AP07765
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2371525
—
LA
Enumeration date
01/29/2014
Last updated
08/22/2024
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