Lacie Parmenter, RN

Individual provider Active NPI General Practice Registered Nurse · Polacca, AZ

NPI 1851996425 · NPPES record last updated Dec 2, 2020

Key facts

NPI
1851996425
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
56830 (ID)
Practice address
Highway 264 Mile Post 388
Polacca, AZ 86042
Phone
(928) 737-6000
NPI assigned
Dec 2, 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
56830IDMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 56830 ID Yes

Addresses

Primary practice location

Highway 264 Mile Post 388
Polacca, AZ 86042

Mailing address

PO Box 436
Polacca, AZ 86042-0436
Phone (208) 206-5014

Other providers in Polacca, AZ

All providers in Polacca, AZ · General Practice Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.