Individual
LACEY G SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9080 TAYLORSVILLE RD, LOUISVILLE, KY 40299-1750
(502) 412-0597
Mailing address
1600 ORMSBY STATION CT, LOUISVILLE, KY 40223-4039
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3014019
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3014019
LICENSE NUMBER
KY
Enumeration date
02/05/2020
Last updated
03/29/2022
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