Provider Demographics
NPI:1235713918
Name:RINKER, LACEY EVALYNN (RN)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:EVALYNN
Last Name:RINKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PHOENIX MILLS RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-5716
Mailing Address - Country:US
Mailing Address - Phone:607-544-2654
Mailing Address - Fax:607-544-2716
Practice Address - Street 1:128 PHOENIX MILLS RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-5716
Practice Address - Country:US
Practice Address - Phone:607-544-2600
Practice Address - Fax:607-544-2716
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY660070163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse