Individual provider · Type 1 NPI
Lacey Lee Wilson
Nurse Practitioner · Phoenix, AZ
Practice location
4859 N 20th St
Phoenix, AZ 85016-4707
Mailing address
735 E Gary Ln
Phoenix, AZ 85042-6647
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 315636 (AZ) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1104646793
Lacey Lee Wilson's National Provider Identifier is 1104646793, issued on Oct 16, 2024. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 16, 2024.