Individual
LACIE WITTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1180 N 300 E, ANDERSON, IN 46012-9748
(765) 387-0193
(765) 387-0321
Mailing address
1039 MONTICELLO DR, ANDERSON, IN 46011-1223
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71017880A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/28/2026
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