Individual
ALEXANDRA LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
216 JEAN DR, HUBBARD, OH 44425-1665
(330) 984-1620
Mailing address
525 E MARKET ST, AKRON, OH 44304-1619
(330) 375-3043
(330) 706-4856
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
57007374RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50007374RX
STATE LICENSE
OH
Enumeration date
03/16/2021
Last updated
05/01/2023
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