Individual
LACEY MC COY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
339 ESTORNINO LN, EL CAJON, CA 92021-4220
(619) 403-3432
Mailing address
339 ESTORNINO LN, EL CAJON, CA 92021-4220
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
704582
CA
163WH0200X
Home Health Registered Nurse
704582
CA
Other
Enumeration date
12/12/2015
Last updated
12/12/2015
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