Individual
LACEY KOLB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2 EASTON OVAL STE 115, COLUMBUS, OH 43219-6036
(614) 934-6890
(216) 831-2726
Mailing address
2 EASTON OVAL STE 115, COLUMBUS, OH 43219-6036
(615) 934-6890
(216) 831-2726
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17701
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139533
—
OH
Enumeration date
07/17/2015
Last updated
09/25/2019
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