Individual
LACEY NOLEN KLECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
6651 MAIN ST STE E1920, HOUSTON, TX 77030-2428
(832) 826-5967
Mailing address
6651 MAIN ST STE E1920, HOUSTON, TX 77030-2428
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP135868
TX
363LP2300X
Primary Care Nurse Practitioner
AP135868
TX
Other
Enumeration date
11/21/2017
Last updated
01/06/2020
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