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General NPI Number Information
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NPI Number | 1568376028
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Entity Type | Individual
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Provider Name | LACEY THUL BSN, RN
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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 | 5148 S KANSAS AVE
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City | WICHITA
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State | KS
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Zip | 67216-3230
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Country | US
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Telephone | 316-973-1250
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Fax | 316-973-1260
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Provider Business Mailing Address
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Address Line | 11210 W CARR CT
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City | WICHITA
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State | KS
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Zip | 67209-4246
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Country | US
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Telephone | 316-992-1015
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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 | 13-127693-082
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 13-127693-082
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License Number State | KS
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