Individual
MRS. SUSAN GENE LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC MSN WHNP
Contact information
Practice address
1905 W 32ND STREET, SUITE 306, JOPLIN, MO 64804-1512
(417) 624-2111
(417) 624-1551
Mailing address
PO BOX 2067, JOPLIN, MO 64804-2067
(417) 624-2111
(417) 624-1551
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
129117
MO
Other
Enumeration date
09/22/2006
Last updated
02/17/2012
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