| NPI | 1710361860 |
|---|---|
| Former Name | LACY LEIGH BURLESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010301) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 803366) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95003937) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2022-05-04 |