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Individual

LACY DIANE WESTFALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1116 WALNUT DR, ARDMORE, OK 73401-2353
(580) 223-6054
(580) 226-2284
Mailing address
1116 WALNUT DR, ARDMORE, OK 73401-2353
(580) 226-0543
(580) 226-6213

Taxonomy

Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
201543
OK
363LW0102X
Women's Health Nurse Practitioner
Primary
201543
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201064730A
OK
Enumeration date
03/23/2021
Last updated
06/28/2022
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