LACEY LEE WILSON

PHOENIX, AZ
NPI1104646793
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: AZ  315636)
Enumeration Date2024-10-16
Last Update Date2024-10-16
Business Address
MISS LACEY LEE WILSON
4859 N 20TH ST
PHOENIX, AZ 85016-4707
Phone number: 602-669-3850
Mailing Address
MISS LACEY LEE WILSON
735 E GARY LN
PHOENIX, AZ 85042-6647
Phone number: 602-814-2852