Individual provider · Type 1 NPI

Lacey Wickersham, APRN

Family Nurse Practitioner · Ontario, OR

NPI number 1710716824 Active

Practice location

896 Fortner St
Ontario, OR 97914-1787

Mailing address

1441 NE 10th Ave
Payette, ID 83661-5420

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X10026939 (OR)

Family Nurse Practitioner: Definition to come...

9 other providers at this address

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About NPI 1710716824

Lacey Wickersham, APRN's National Provider Identifier is 1710716824, issued on Jul 29, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Ontario, OR. The record was last updated on Jan 15, 2026.