Raiche, Lacey Jo

Raiche, Lacey Jo is an individual health care provider with primary practice located at 3603 Schneider Avenue , Menomonie WI 54751-5674. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Raiche, Lacey Jo can be contacted via phone (715) 233-6400.

Contact Information

Primary practice address
3603 Schneider Avenue Menomonie WI 54751-5674
Phone: (715) 233-6400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R207746-8 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 162013-30 Wisconsin

Profile Details

NPI number 1679834857
LBN Legal business name Raiche, Lacey Jo
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2012
Last updated Mar 31st, 2021 - about 5 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 1679834857 NPPES
Minnesota MEDICAID 1679834857

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