Provider Demographics
NPI:1487151833
Name:EMERINE, LACIE A (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:LACIE
Middle Name:A
Last Name:EMERINE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-4263
Mailing Address - Fax:614-685-4768
Practice Address - Street 1:2121 KENNY RD FL 5
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-3100
Practice Address - Country:US
Practice Address - Phone:614-685-4263
Practice Address - Fax:614-685-4768
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023300363LF0000X
OHF07181293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF07181293OtherAANP