Individual
LACEY LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1128 TX-21, BASTROP, TX 78602-4298
(844) 215-4498
Mailing address
16800 LUND RD N, ELGIN, TX 78621-3830
(512) 413-5190
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
AP125777
TX
363LF0000X
Family Nurse Practitioner
AP125777
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP125777
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342462401
—
TX
01
—
791283
RN LICENSE
TX
01
—
AP125777
APRN LICENSE NO.
TX
Enumeration date
06/12/2014
Last updated
08/29/2024
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