Individual
MS. LACEY ANNE CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
300 HIGH POINT CT, MOUNT WASHINGTON, KY 40047-6560
(502) 955-6129
Mailing address
317 TYNE RD, LOUISVILLE, KY 40207-3445
(502) 436-5989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3014392
KY
363LF0000X
Family Nurse Practitioner
Primary
3014392
KY
Other
Enumeration date
03/30/2020
Last updated
03/22/2022
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