Healthcare Provider Details

I. General information

NPI: 1497502421
Provider Name (Legal Business Name): LACEY ROWSON APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E 2ND ST STE 300
RENO NV
89502-1175
US

IV. Provider business mailing address

1155 MILL ST # MSM14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-5000
  • Fax: 775-982-3900
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number874027
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number874027
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: