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General NPI Number Information
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NPI Number | 1710867528
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Entity Type | Individual
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Provider Name | ALICIA MARIE LACEY RN, AGACNP
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 3537 S I 35 E STE 305
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City | DENTON
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State | TX
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Zip | 76210-6803
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Country | US
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Telephone | 940-384-4599
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Fax | 469-713-0207
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Provider Business Mailing Address
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Address Line | 2408 INDIAN HEAD DR
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City | FORT WORTH
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State | TX
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Zip | 76177-2068
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Country | US
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Telephone | 817-996-0522
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1216140
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License Number State | TX
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