Individual
ELIZABETH LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
106 JOHN ST, EASLEY, SC 29640-1415
(864) 859-2220
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6306
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21709
SC
Other
Enumeration date
02/08/2019
Last updated
04/02/2019
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