Lacey Henry

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

270374 Issued in AZ

Practice address

10647 E Vivid Ave
Mesa, AZ 85212-8053

Phone

(602) 451-6443

NPI assigned

Sep 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1124853759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10647 E VIVID AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128053",
            "telephone_number": "602-451-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10647 E VIVID AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128053",
            "telephone_number": "602-451-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "270374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew W. Henninger, PHD
• Waahidah Hennix
• Henry M Luedy MD PLLC
• Camilla Henry, RDN
• Carmen Lynn Henry, FNP
• Paula Henry, COTA
• Susan Jean Henry, BS, CLINICIAN I
• Wallace Henry Jr.
• Caroline Anne Hensley, BSN, RN
• Blake Henson, OD

• Registered Nurse in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.