Individual
LACEY HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
416 W CAMP ST, LEBANON, IN 46052-1799
(765) 742-1567
(465) 483-4495
Mailing address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2173
(765) 742-1567
(765) 429-2700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28168869A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201119670
—
IN
Enumeration date
09/25/2012
Last updated
10/29/2020
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