Individual
DEBRA LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
HWY 18, PINE RIDGE, SD 57770
(605) 867-5131
(605) 867-3097
Mailing address
POB 1201, HWY 18, PINE RIDGE, SD 57770
(605) 867-5131
(605) 867-3097
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R032781
SD
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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