Individual
WENDY K LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 872-7388
(513) 872-7385
Mailing address
3200 BURNET AVE, 3 SOUTH, CINCINNATI, OH 45229-3019
(513) 585-5503
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN235752
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200219330
—
IN
05
—
2173179
—
OH
05
—
74499823
—
KY
Enumeration date
07/12/2006
Last updated
01/03/2013
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