Individual
JENNIFER LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
315 W HICKORY ST, SYLACAUGA, AL 35150-2913
(406) 600-9186
(781) 937-6442
Mailing address
PO BOX 202712, DALLAS, TX 75320-2712
(866) 961-6774
(781) 937-6442
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-107400
AL
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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