Individual
LACY BROOKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, CPNP-AC
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 417-2225
Mailing address
921 S LINFORD DR, STILLWATER, OK 74074-5863
(405) 612-6910
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R0109120
OK
363LA2100X
Acute Care Nurse Practitioner
Primary
AP61620861
WA
Other
Enumeration date
03/29/2022
Last updated
11/04/2024
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