Lacey Bryant

Key facts

NPI

1063271997

Entity type

Individual (NPI type 1)

Primary specialty

Continuing Education/Staff Development Registered Nurse 163WC1600X

License

28217762A (IN)

Practice address

831 Timber Crest Rd
Nashville, IN 47448-8310

Phone

(812) 343-7396

NPI assigned

Mar 14, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 14, 2024.

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1063271997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 TIMBER CREST RD",
            "city": "NASHVILLE",
            "state": "IN",
            "postal_code": "474488310",
            "telephone_number": "812-343-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 TIMBER CREST RD",
            "city": "NASHVILLE",
            "state": "IN",
            "postal_code": "474488310",
            "telephone_number": "812-343-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "IN",
            "license": "28217762A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Nashville, IN · Continuing Education/Staff Development Registered Nurse in Indiana