Provider Demographics
NPI:1649016957
Name:WEST, LACEY ANNE (STUDENT, PHD)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:ANNE
Last Name:WEST
Suffix:
Gender:F
Credentials:STUDENT, PHD
Other - Prefix:MS
Other - First Name:LACEY
Other - Middle Name:ANNE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1314 S MCHENRY ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1314 S MCHENRY ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2710
Practice Address - Country:US
Practice Address - Phone:816-352-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program