Individual
LACEY GOLDEN
Active
Individual
LACEY GOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.638
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04957385
—
MS
01
—
051114784
BCBS
AL
01
—
051114785
BCBS
AL
01
—
051114787
BCBS
AL
05
—
127143
—
AL
05
—
127144
—
AL
Enumeration date
12/13/2010
Last updated
01/21/2019
Update your record
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