Individual
LACEY JEAN KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-3522
(608) 263-6400
(608) 262-6743
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6084-33
WI
363LP2300X
Primary Care Nurse Practitioner
6084
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396142253
—
WI
Enumeration date
11/20/2014
Last updated
10/24/2022
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