Provider Demographics
NPI:1891416079
Name:LACROIX, KARIEF JANEEL (CNM)
Entity type:Individual
Prefix:
First Name:KARIEF
Middle Name:JANEEL
Last Name:LACROIX
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 SOUTHERN WALK TER
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-2925
Mailing Address - Country:US
Mailing Address - Phone:404-822-9084
Mailing Address - Fax:
Practice Address - Street 1:565 OLD NORCROSS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4308
Practice Address - Country:US
Practice Address - Phone:770-338-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN209770363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology