Individual
LACY A. SCHNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2115 S FREMONT AVE, SUITE 4300, SPRINGFIELD, MO 65804-2239
(417) 820-3911
(417) 820-3924
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2003004359
MO
363LF0000X
Family Nurse Practitioner
Primary
2013022811
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
06/27/2013
Last updated
07/09/2013
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