Individual
LACEY BERNICE IVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112-4418
(405) 949-3011
Mailing address
14000 HUNTER JACKSON DR, YUKON, OK 73099-1018
(405) 464-8515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201078
OK
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
201078
OK
363LF0000X
Family Nurse Practitioner
201078
OK
Other
Enumeration date
08/28/2024
Last updated
03/09/2026
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