MEDICARE: LACIE KILLIAN CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist	180788	KS

General Provider Information

NPI Number	:	1205379468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACIE KILLIAN CNA

Provider Business Mailing Address
First Line	:	1700 AVENUE G
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-4544
Country	:	US
Telephone Number	:	620-255-8006
Fax Number	:	620-371-7304

Provider Business Practice Location Address
First Line	:	1700 AVENUE G
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-4544
Country	:	US
Telephone Number	:	620-255-8006
Fax Number	:	620-371-7304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

Similar Medicare Providers

1518959295 — DR. BONNIE JEAN LEES MD
Practice Location Address:

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398

1093594194 — HEPATOALLAH YOUSSEF
Practice Location Address:

3525H ELLICOTT MILLS DR STE 105
ELLICOTT CITY, MD
21043-4544

Practice Phone: 410-429-0539
Practice Fax:

1629164652 — KATHRYN MARIE WESTLEIN LCSW-C
Practice Location Address:

3565 C2 ELLICOTT MILLS DR , SUITE 101
ELLICOTT CITY, MD
21043-4544

Practice Phone: 410-916-0280
Practice Fax: 443-592-9006

1467783811 — MRS. LESLY THREADGILL OGUNGBEMI MSW - LCSW-C
Practice Location Address:

3525H ELLICOTT MILLS DR STE 108
ELLICOTT CITY, MD
21043-4544

Practice Phone: 410-212-0111
Practice Fax:

1689967531 — INDIVIDUAL CONTRACTOR
Practice Location Address:

4711 SE 77TH ST
OKLAHOMA CITY, OK
73135-4544

Practice Phone: 405-921-3430
Practice Fax:

1194093898 — CRYSTAL L MORGAN-WALLS
Practice Location Address:

4711 SE 77TH ST
OKLAHOMA CITY, OK
73135-4544

Practice Phone: 405-921-3430
Practice Fax:

Directions to “ LACIE KILLIAN CNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.