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1376895961
LAURIE LEIGH LACKLAND
PRESCOTT, AZ
NPI
1376895961
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: AZ AP4680)
Enumeration Date
2012-10-08
Last Update Date
2014-07-02
Business Address
Ms. LAURIE LEIGH LACKLAND ANP
1065 RUTH ST
PRESCOTT, AZ 86301-1729
Phone number: 928-778-5655
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Mailing Address
Ms. LAURIE LEIGH LACKLAND ANP
PO BOX 2104
PRESCOTT, AZ 86302-2104
Phone number: 805-506-1649
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