Provider Demographics
NPI:1699394981
Name:HUTCHESON, LACEY JUNE (APRN)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:JUNE
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6607
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0607
Mailing Address - Country:US
Mailing Address - Phone:402-483-3333
Mailing Address - Fax:402-483-3297
Practice Address - Street 1:1500 S 48TH ST STE 400
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1278
Practice Address - Country:US
Practice Address - Phone:402-481-8500
Practice Address - Fax:402-481-8501
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE79706163W00000X
NE113153363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse