Provider Demographics
NPI:1497087530
Name:ARRISON, JACY ANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JACY
Middle Name:ANNE
Last Name:ARRISON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1952
Mailing Address - Country:US
Mailing Address - Phone:717-380-6482
Mailing Address - Fax:
Practice Address - Street 1:38 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1952
Practice Address - Country:US
Practice Address - Phone:717-380-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN281490164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse