Provider Demographics
NPI:1215759436
Name:PERRY, LACIE CHALAYNE
Entity type:Individual
Prefix:
First Name:LACIE
Middle Name:CHALAYNE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 FLINT DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4385
Mailing Address - Country:US
Mailing Address - Phone:913-908-7561
Mailing Address - Fax:
Practice Address - Street 1:7231 FLINT DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4385
Practice Address - Country:US
Practice Address - Phone:913-908-7561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula