Healthcare Provider Details

I. General information

NPI: 1508282955
Provider Name (Legal Business Name): BRITTANY LACY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 ALBERT PIKE RD
HOT SPRINGS AR
71913-4514
US

IV. Provider business mailing address

2605 ALBERT PIKE RD
HOT SPRINGS AR
71913-4514
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-1144
  • Fax: 501-767-4455
Mailing address:
  • Phone: 501-767-1144
  • Fax: 501-767-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA004026
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: