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General NPI Number Information
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NPI Number | 1407760929
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Entity Type | Individual
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Provider Name | LACEY MICHELLE LAINE APRN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 8040 HOSBROOK RD STE 320
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City | CINCINNATI
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State | OH
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Zip | 45236-2908
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Country | US
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Telephone | 513-939-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 83 MILLER LN
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City | FORT THOMAS
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State | KY
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Zip | 41075-1838
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Country | US
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Telephone | 513-374-2159
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0043529
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License Number State | OH
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