Individual
LACEY J WHITE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4376 GERMANNA HWY, LOCUST GROVE, VA 22508-2008
(540) 972-7798
(540) 972-3536
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0110010466
VA
363A00000X
Physician Assistant
0010-05970
NC
363A00000X
Physician Assistant
Primary
0110010466
VA
363A00000X
Physician Assistant
Primary
PA56584
CA
Other
Enumeration date
08/10/2015
Last updated
02/11/2026
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