Individual
LACEY WICKERSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
896 FORTNER ST, ONTARIO, OR 97914-1787
(541) 881-2828
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(541) 881-2828
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10026939
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500844300
—
OR
Enumeration date
07/29/2024
Last updated
01/15/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us