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AQUARIUS M LACEY RN

Individual Provider (NPI-1) Active

Registered Nurse

Provider Information

NPI Number
1407592074
Provider Type
Individual Provider (NPI-1)
Credentials
RN
Status
Active

Contact & Location

Address
39104 PRAIRIE SOUTH DR, GONZALES, LA, 707379510
Phone
(225) 400-1376

Specialties & Taxonomies

Registered Nurse, Community Health License: LA #20130166
Registered Nurse, Home Health License: LA #20130166
Registered Nurse Primary License: LA #20130166

All Addresses

MAILING

39104 PRAIRIE SOUTH DR

GONZALES, LA, 707379510

(225) 400-1376

LOCATION

39104 PRAIRIE SOUTH DR

GONZALES, LA, 707379510

(225) 400-1376