Individual
LACI C CAUDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1310 W BLOOMFIELD RD STE C, BLOOMINGTON, IN 47403-2001
(812) 334-2772
(812) 323-7347
Mailing address
1310 W BLOOMFIELD RD STE C, BLOOMINGTON, IN 47403-2001
(812) 334-2772
(812) 323-7347
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71011324A
IN
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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