Individual
MRS. LACEY RENEE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1950 DIAMOND PARKWAY, SUITE 100, N. KANSAS CITY, MO 64116
(816) 561-3003
(816) 889-1584
Mailing address
1950 DIAMOND PARKWAY, SUITE 100, N. KANSAS CITY, MO 64116
(816) 561-3003
(816) 889-1584
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2015004697
MO
Other
Enumeration date
07/21/2011
Last updated
01/10/2024
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