Lacie J Hearron, RN

Individual provider Active NPI Registered Nurse · Colbert, WA

NPI 1366069882 · NPPES record last updated Jun 30, 2020

Key facts

NPI
1366069882
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN60071718 (WA)
Practice address
6115 E Greenbluff Rd
Colbert, WA 99005-9525
Phone
(509) 939-7269
NPI assigned
Jun 30, 2020
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60071718WAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60071718 WA Yes

Addresses

Primary practice location

6115 E Greenbluff Rd
Colbert, WA 99005-9525

Mailing address

6115 E Greenbluff Rd
Colbert, WA 99005-9525
Phone (509) 939-7269

Other providers in Colbert, WA

All providers in Colbert, WA · Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.