person
Mrs. Lacey Sullivan, FNP-BC
Family Nurse Practitioner in Farmington, Missouri
NPI 1174951503

Lacey Sullivan is a Family Nurse Practitioner based in Farmington, MO and is specialized in Family. Lacey Sullivan practices in Farmington, MO and has the professional credentials of FNP-BC. The NPI Number for Lacey Sullivan is 1174951503 and holds a License No. 2013037701 (Missouri).

The current practice location address for Lacey Sullivan is 618 Maple Valley Dr, Farmington, MO and can be reached out via phone at 573-756-3400 and via fax at 573-756-0800. You can also correspond with Lacey Sullivan through the mailing address at 608 MAPLE VALLEY DR, FARMINGTON, MO - 63640-1976 (mailing address contact number: 573-756-3400).

Location: 618 Maple Valley Dr, Farmington, MO, 63640-1976
person
Provider Profile Details
NPI Number
1174951503
Provider Name
Lacey Sullivan
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Female
Address
618 Maple Valley Dr, Farmington, MO, 63640-1976
Phone Number
573-756-3400
Fax Number
573-756-0800
Provider Enumeration Date
10/22/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2013037701 01 MO FNP LICENSE
2008021920 01 MO RN LICENSE
2013017822 01 MO ANCC
institution
Provider Business Practice Location Address Details
Address
618 Maple Valley Dr
City
State
Zip
63640
Phone Number
573-756-3400
Fax Number
573-756-0800
person
Provider Business Mailing Address Details
Address
608 Maple Valley Dr
City
State
Zip
63640-1976
Phone Number
573-756-3400
Fax Number
573-756-0800
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
2013037701 (Missouri)
Definition
Definition to come...
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