Provider Demographics
NPI:1457995243
Name:ERNEY, LACEY (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:ERNEY
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 ATTUCKS DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6082
Mailing Address - Country:US
Mailing Address - Phone:614-797-0975
Mailing Address - Fax:
Practice Address - Street 1:3821 ATTUCKS DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6082
Practice Address - Country:US
Practice Address - Phone:614-797-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH025731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily