Individual
MRS. LACIE PARMENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
HIGHWAY 264 MILE POST 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
PO BOX 436, POLACCA, AZ 86042-0436
(208) 206-5014
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
56830
ID
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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