Individual
KATHERINE LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E LANCASTER AVE, HEART PAVILION MEZZANINE LEVEL, WYNNEWOOD, PA 19096-3450
(484) 476-1000
Mailing address
3803 W CHESTER PIKE STE 160, NEWTOWN SQUARE, PA 19073-2336
(484) 476-1000
(484) 476-9000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP032461
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
SP032461
PA
Other
Enumeration date
09/22/2025
Last updated
02/07/2026
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