Lacey Nelson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10316492-4102 Issued in UT

Practice address

4035 S 500 E
Murray, UT 84107-1866

Phone

(801) 262-9181

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lacey Gardell Professional name

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1821594532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S FOOTHILL DR APT 203G",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841093933",
            "telephone_number": "254-855-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 S 500 E",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841071866",
            "telephone_number": "801-262-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SLP6929",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "10316492-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "GARDELL",
            "credential": "M.S., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Edward Thomas Nelson, M.D.
• Gail A Nelson, APRN
• Kendall Katherine Nelson, APRN
• Kim Nelson, PT
• Kristin Nelson
• Mykala Mikesell Nelson, DNP, FNP-C, BSN, RN
• Olivia Nelson, PA-C
• Patricia L Nelson, M.D.
• Ryan William Nelson, MD
• Sunny Blue Alene Nelson, PA-C

• Speech-Language Pathologist in Murray, UT
• Providers in Murray, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.