Healthcare Provider Details

I. General information

NPI: 1821846916
Provider Name (Legal Business Name): LACEY LETECIA MORRIS-WRIGHT AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MADISON AVE STE 306
MORRISTOWN NJ
07960-6389
US

IV. Provider business mailing address

37 BROOKLYN RD
STANHOPE NJ
07874-2865
US

V. Phone/Fax

Practice location:
  • Phone: 973-695-8033
  • Fax:
Mailing address:
  • Phone: 571-992-3359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ14997000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ14997000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: