| NPI | 1548713290 | 
|---|---|
| Former Name | LACEY WERNER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71006524A) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28187969A) | 
| Enumeration Date | 2016-07-29 | 
| Last Update Date | 2021-06-15 |