Individual
LACY GEORGETTE IRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1000 N BROADWAY, PERU, IN 46970-1070
(765) 472-5335
Mailing address
1000 N BROADWAY, PERU, IN 46970-1070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28188363A
IN
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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