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 |