Provider Demographics
NPI:1427712181
Name:ENGELSTAD, LACY MARIE (NP)
Entity type:Individual
Prefix:MS
First Name:LACY
Middle Name:MARIE
Last Name:ENGELSTAD
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3815 N SCHREIBER WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8362
Mailing Address - Country:US
Mailing Address - Phone:208-758-0920
Mailing Address - Fax:208-765-0277
Practice Address - Street 1:1701 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2537
Practice Address - Country:US
Practice Address - Phone:208-625-4950
Practice Address - Fax:208-625-4951
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2023-09-16
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Provider Licenses
StateLicense IDTaxonomies
ID70390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner