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Individual

MRS. LACCEY LOUISE CRIMMINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
802 KENYON RD, FORT DODGE, IA 50501-5740
(515) 573-3101
(515) 574-6754
Mailing address
2476 170TH ST, FORT DODGE, IA 50501-8555
(515) 408-5155
(515) 574-6754

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A162720
IA
363LF0000X
Family Nurse Practitioner
A162720
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F01210805
IA
Enumeration date
01/27/2021
Last updated
03/04/2022
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