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1083479539
TAYLOR LACKEY
MENASHA, WI
NPI
1083479539
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WI 15030)
Enumeration Date
2024-02-14
Last Update Date
2024-02-14
Business Address
TAYLOR LACKEY
1095 MIDWAY RD
MENASHA, WI 54952-1115
Phone number: 920-720-2300
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Mailing Address
TAYLOR LACKEY
1095 MIDWAY RD
MENASHA, WI 54952-1115
Phone number:
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