Individual
MRS. KRYSTAL ANN LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3141 N 3RD AVE STE 100, PHOENIX, AZ 85013-4351
(602) 745-7900
Mailing address
3141 N 3RD AVE STE 100, PHOENIX, AZ 85013-4351
(602) 745-7900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN125367
AZ
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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