| NPI | 1407256696 |
|---|---|
| Former Name | MEGHAN LOU LACEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OH 2014016073) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: OH 2014016073) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2020-04-23 |