Individual
LACEY HILLERMAN CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
203 NW R D MIZE RD, SUITE 200, BLUE SPRINGS, MO 64014-2510
(816) 220-1117
(816) 228-2053
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4662
(417) 347-9453
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016025285
MO
Other
Enumeration date
02/13/2017
Last updated
08/30/2019
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