| NPI | 1245782549 |
|---|---|
| Former Name | LACEY R HERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017002573) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MO 2011032659) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2017-02-15 |