Individual provider Active NPI

Lacey Kay Bruner, PHARMD

  • Pharmacist
  • Elysburg, PA
National Provider Identifier
1033700331
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP444687 Issued in PA
Practice address
210 Industrial Park Rd
Elysburg, PA 17824-9770
Phone
(844) 878-5562
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP444687 PA Primary

Addresses

Primary practice location

210 Industrial Park Rd
Elysburg, PA 17824-9770

Mailing address

210 Industrial Park Rd
Elysburg, PA 17824-9770
Phone (844) 878-5562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP444687PAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1033700331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INDUSTRIAL PARK RD",
            "city": "ELYSBURG",
            "state": "PA",
            "postal_code": "178249770",
            "telephone_number": "844-878-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 INDUSTRIAL PARK RD",
            "city": "ELYSBURG",
            "state": "PA",
            "postal_code": "178249770",
            "telephone_number": "844-878-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "LACEY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP444687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.