AQUARIUS M LACEY

GONZALES, LA
NPI1407592074
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: LA  20130166)
Additional Taxonomies163WC1500X Registered Nurse, Community Health
(Licence: LA  20130166)
163WH0200X Registered Nurse, Home Health
(Licence: LA  20130166)
Enumeration Date2022-05-06
Last Update Date2022-05-06
Business Address
AQUARIUS M LACEY RN
39104 PRAIRIE SOUTH DR
GONZALES, LA 70737-9510
Phone number: 225-400-1376
Mailing Address
AQUARIUS M LACEY RN
39104 PRAIRIE SOUTH DR
GONZALES, LA 70737-9510
Phone number: 225-400-1376