Individual
LACEY BEARD MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1781 E COTTONWOOD RD, DOTHAN, AL 36301-5309
(334) 678-5851
(334) 678-2803
Mailing address
201 MONROE ST STE 1600, MONTGOMERY, AL 36104-3721
(334) 206-9344
(334) 206-3715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-37700
AL
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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