Individual
VICTORIA W LACASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
18 OLD ETNA RD, LEBANON, NH 03766
(603) 650-4000
(603) 650-4090
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
067106-23
NH
363L00000X
Nurse Practitioner
101.00742949
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018407
—
VT
Enumeration date
11/23/2010
Last updated
05/10/2013
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