Individual
ASHLEY COBY LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
19707 US HIGHWAY 280 E, APT 1309, SMITHS STATION, AL 36877-4031
(256) 572-5936
Mailing address
2986 US HIGHWAY 431, BOAZ, AL 35957-5848
(256) 572-5936
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-122189
AL
Other
Enumeration date
02/27/2012
Last updated
05/19/2022
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