Individual
LACY SUNDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
102 CARY CT, GOOSE CREEK, SC 29445-7009
(303) 885-7456
Mailing address
102 CARY CT, GOOSE CREEK, SC 29445-7009
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.277553
SC
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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