Individual
LACIE L FEDEWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2997 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4405
(719) 355-7333
(719) 465-2015
Mailing address
15101 E ILIFF AVE STE 140, AURORA, CO 80014-4548
(720) 878-7055
(720) 390-5188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704254325
MI
363LF0000X
Family Nurse Practitioner
Primary
APN.0993372-NP
CO
Other
Enumeration date
09/15/2011
Last updated
06/18/2025
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