Provider Demographics
NPI:1669058814
Name:OWINGS, LACEE (RN)
Entity type:Individual
Prefix:
First Name:LACEE
Middle Name:
Last Name:OWINGS
Suffix:
Gender:F
Credentials:RN
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 7
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-0007
Mailing Address - Country:US
Mailing Address - Phone:410-374-1414
Mailing Address - Fax:410-374-1443
Practice Address - Street 1:3128 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1893
Practice Address - Country:US
Practice Address - Phone:410-374-1414
Practice Address - Fax:410-374-1443
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201473163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR201473OtherMARYLAND BOARD OF NURSING