Active NPI
Lacey Lyn Schafer, NP-BC
- Adult Health Nurse Practitioner
- Plymouth, WI
National Provider Identifier
1306088265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 3692-33
- Practice address
- W9071 Forest Dr
Plymouth, WI 53073 - Phone
- (920) 526-9206
- Fax
- (920) 526-3819
- NPI assigned
- Mar 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 3692-33 | WI | Primary |
Addresses
Primary practice location
W9071 Forest Dr
Plymouth, WI 53073
Mailing address
310 19TH St
Fond Du Lac, WI 54935-6253
Phone (920) 238-9915
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3692-33 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237852800000",
"number": "1306088265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 19TH ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549356253",
"telephone_number": "920-238-9915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W9071 FOREST DR",
"city": "PLYMOUTH",
"state": "WI",
"postal_code": "53073",
"telephone_number": "920-526-9206",
"fax_number": "920-526-3819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAFER",
"first_name": "LACEY",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "NP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-24",
"last_updated": "2009-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "3692-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.