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LACIE PAXTON APRN

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1720618341

Individual Registrant:
 LACIE  PAXTON APRN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
133 COUNTY ROAD 207A  EAST PALATKA, FL 32131-4150 US
Tel: 904-662-5375  Fax: --

Contact information for business:
133 COUNTY ROAD 207A  EAST PALATKA, FL 32131-4150 US
Tel: 904-662-5375  Fax: --

Registration Information:
NPI: 1720618341
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
FLAPRN11005797

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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