Individual
MRS. LACEY LYN SCHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
W9071 FOREST DR, PLYMOUTH, WI 53073
(920) 526-9206
(920) 526-3819
Mailing address
310 19TH ST, FOND DU LAC, WI 54935-6253
(920) 238-9915
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3692-33
WI
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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