Provider Demographics
NPI:1154018737
Name:WEST, LACEY DEE (FNP-C)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:DEE
Last Name:WEST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W PARSONAGE ST
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:TX
Mailing Address - Zip Code:79567-4611
Mailing Address - Country:US
Mailing Address - Phone:325-998-2421
Mailing Address - Fax:
Practice Address - Street 1:612 W PARSONAGE ST
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:TX
Practice Address - Zip Code:79567-4611
Practice Address - Country:US
Practice Address - Phone:325-998-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116154363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily