Lacey, Mary

Lacey, Mary is an individual health care provider with primary practice located at 350 Hospital Dr , Macon GA 99508-4615. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is her primary health care specialty. Lacey, Mary can be contacted via phone (478) 765-4132.

Contact Information

Primary practice address
350 Hospital Dr Macon GA 99508-4615
Phone: (478) 765-4132
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X RN182787 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X 794 Alaska

Profile Details

NPI number 1902096399
LBN Legal business name Lacey, Mary
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2007
Last updated Apr 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902096399 NPPES
Georgia MEDICAID RN182787
Georgia MEDICAID NP0794

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