Provider Demographics
NPI:1699575761
Name:WRIGHT, LACEY
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 STATE HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69340-7106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2975 STATE HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69340-7106
Practice Address - Country:US
Practice Address - Phone:607-759-7078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant