Healthcare Provider Details

I. General information

NPI: 1437876638
Provider Name (Legal Business Name): LACY LEMASTER HOWTON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PILOT MEDICAL DR STE 300
BIRMINGHAM AL
35235-3412
US

IV. Provider business mailing address

117 ALABAMA BLVD
TRUSSVILLE AL
35173-2552
US

V. Phone/Fax

Practice location:
  • Phone: 205-856-2284
  • Fax:
Mailing address:
  • Phone: 205-948-7375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-171626
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: