Individual
DAVID EDWARD LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4003 KRESGE WAY STE 410, LOUISVILLE, KY 40207-4652
(502) 893-7462
Mailing address
5725 WAVELAND CIR, PROSPECT, KY 40059-8666
(704) 806-5905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3015534
KY
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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