Individual
LACY ELIZABETH SCOTT WYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
1587 NW WASHINGTON BLVD, GRANTS PASS, OR 97526-1085
(541) 476-7000
Mailing address
1701 NE 7TH ST, GRANTS PASS, OR 97526-1319
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
20163827
OR
363LF0000X
Family Nurse Practitioner
Primary
201605315
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500713269
—
OR
Enumeration date
04/27/2015
Last updated
07/14/2025
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