Individual
LACEY CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 JACKSON AVE, NORTHFIELD, NJ 08225-1631
(609) 383-0200
(609) 383-8352
Mailing address
510 JACKSON AVE, NORTHFIELD, NJ 08225-1631
(609) 383-0200
(609) 383-8352
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00579200
NJ
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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