Healthcare Provider Details

I. General information

NPI: 1962327205
Provider Name (Legal Business Name): LACEY NIEHUES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 8TH ST
ONAGA KS
66521-9574
US

IV. Provider business mailing address

414 STATE HIGHWAY 62
GOFF KS
66428-9753
US

V. Phone/Fax

Practice location:
  • Phone: 785-889-5001
  • Fax:
Mailing address:
  • Phone: 785-456-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-117408-122
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: