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General NPI Number Information
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NPI Number | 1619114055
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Entity Type | Individual
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Provider Name | LACY BABBY REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | HWY 18 SOLDIER CREEK ROAD ROSEBUD IHS HOSPITAL
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City | ROSEBUD S
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State | SD
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Zip | 57570
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Country | US
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Telephone | 605-747-2231
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Fax | 605-747-2216
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Provider Business Mailing Address
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Address Line | HWY 18 SOLDIER CREEK ROAD ROSEBUD IHS HOSPITAL
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City | ROSEBUD S
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State | SD
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Zip | 57570
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Country | US
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Telephone | 605-747-2231
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Fax | 605-747-2216
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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 | R035526
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License Number State | SD
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