Individual
LACY LOEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
900 E CHERRY ST, TROY, MO 63379-1429
(636) 528-8585
Mailing address
900 E CHERRY ST, TROY, MO 63379-1429
(636) 528-8585
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015037602
MO
Other
Enumeration date
10/13/2015
Last updated
12/20/2023
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