| NPI | 1346639267 |
|---|---|
| Former Name | LACEY PENDRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376461022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 115569) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2022-11-29 |