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Individual

MISS LACY ERIN PENROD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
5906 E 31ST ST STE 2, TULSA, OK 74135-5110
(918) 508-7008
Mailing address
5906 E 31ST ST STE 2, TULSA, OK 74135-5110
(918) 508-7008

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
201089
OK

Other

Enumeration date
02/26/2021
Last updated
02/26/2021
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