Provider Demographics
NPI:1376011809
Name:KRIEGEL, LACI (ACAGNP-BC)
Entity Type:Individual
Prefix:
First Name:LACI
Middle Name:
Last Name:KRIEGEL
Suffix:
Gender:F
Credentials:ACAGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CAVELIER DR
Mailing Address - Street 2:
Mailing Address - City:PORT LAVACA
Mailing Address - State:TX
Mailing Address - Zip Code:77979-2022
Mailing Address - Country:US
Mailing Address - Phone:361-571-8555
Mailing Address - Fax:
Practice Address - Street 1:2700 CITIZENS PLZ STE 200
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5756
Practice Address - Country:US
Practice Address - Phone:361-582-7949
Practice Address - Fax:361-582-7945
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139607363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care