LACEY RENEA HANTLA

SUMMERVILLE, SC
NPI1881419877
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  29706)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TX  1178328)
Enumeration Date2024-11-15
Last Update Date2024-12-12
Business Address
LACEY RENEA HANTLA NP
133 E 1ST NORTH ST STE 5
SUMMERVILLE, SC 29483-6873
Phone number: 843-872-1592
Mailing Address
LACEY RENEA HANTLA NP
133 E 1ST NORTH ST STE 5
SUMMERVILLE, SC 29483-6873
Phone number: 843-872-1592