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1720477714
LACEY GRIMES LICHTENSTEIN
GULFPORT, MS
NPI
1720477714
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS F1214550)
Enumeration Date
2015-01-14
Last Update Date
2020-10-27
Business Address
Mrs. LACEY GRIMES LICHTENSTEIN NP-C
1340 BROAD AVE
GULFPORT, MS 39501-2404
Phone number: 228-575-1234
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Mailing Address
Mrs. LACEY GRIMES LICHTENSTEIN NP-C
1340 BROAD AVE
GULFPORT, MS 39501-2404
Phone number: 228-572-1234
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