Individual
LACEY BLOY
Active
Individual
LACEY BLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
136160
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024181458
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001275956
RN LICENSE
VA
Enumeration date
04/29/2021
Last updated
05/22/2023
Update your record
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