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Individual

LACI L THORNTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-BC

Contact information

Practice address
105 BROADWAY ST, VINCENNES, IN 47591-1251
(812) 790-2599
(812) 790-9004
Mailing address
15549 LAKE LAWRENCE RD, LAWRENCEVILLE, IL 62439-4722
(618) 928-1530

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041348592
IL
163W00000X
Registered Nurse
28177544A
IN
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
041348592
IL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
28177544A
IN
363LF0000X
Family Nurse Practitioner
209026582
IL
363LF0000X
Family Nurse Practitioner
Primary
71013870A
IN
363LF0000X
Family Nurse Practitioner
71013870B
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71013870A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041348592
STATE BOARD OF NURSING
IL
01
209026582
STATE BOARD OF NURSING
IL
01
28177544A
STATE BOARD OF NURSING
IN
01
71013870A
STATE BOARD OF NURSING
IN
Enumeration date
06/28/2022
Last updated
04/02/2026
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