Provider Demographics
NPI:1164583894
Name:CAPPS, LACEY ELAINE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:ELAINE
Last Name:CAPPS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 MEMORIAL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5155
Mailing Address - Country:US
Mailing Address - Phone:615-217-6900
Mailing Address - Fax:615-217-6995
Practice Address - Street 1:10644 CONCORD RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8811
Practice Address - Country:US
Practice Address - Phone:615-941-8768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily