Healthcare Provider Details

I. General information

NPI: 1376011809
Provider Name (Legal Business Name): LACI KRIEGEL ACAGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CITIZENS PLZ STE 200
VICTORIA TX
77901-5756
US

IV. Provider business mailing address

2701 HOSPITAL DR
VICTORIA TX
77901-5748
US

V. Phone/Fax

Practice location:
  • Phone: 361-582-7949
  • Fax: 361-582-7945
Mailing address:
  • Phone: 361-582-5771
  • Fax: 361-582-5743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP139607
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: