Individual provider · Type 1 NPI

Tiniya Brandy Lacy, NP

Nurse Practitioner · Apple Valley, CA

NPI number 1649002064 Active

Practice location

18522 US Highway 18 Ste 102
Apple Valley, CA 92307-2321

Call (760) 242-7707 Map

Fax (760) 242-1133

Mailing address

11797 Forest Park Ln
Victorville, CA 92392-0428

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	95046480 (CA)
Nurse Practitioner Primary	363L00000X	95039016 (CA)

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…

2 other providers at this address

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About NPI 1649002064

Tiniya Brandy Lacy, NP's National Provider Identifier is 1649002064, issued on Aug 14, 2024. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Apple Valley, CA. The record was last updated on Apr 7, 2026.