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General NPI Number Information
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NPI Number | 1023930609
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Entity Type | Individual
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Provider Name | KIANA LACY DNP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 6853 DOUGLASVILLE BLVD SUITE C
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City | DOUGLASVILLE
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State | GA
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Zip | 30135
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Country | US
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Telephone | 770-731-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 465 BUSHER DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-8205
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Country | US
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Telephone | 254-319-1816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 792046
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License Number State | TX
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