Lacey Davis
Individual provider Active NPI Licensed Practical Nurse · Duncan, SC
NPI 1962072777 · NPPES record last updated Jun 25, 2021
Key facts
- NPI
- 1962072777
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 42917 (SC)
- Practice address
- 325 Inglesby Pkwy
Duncan, SC 29334-9117 - Phone
- (864) 433-8443
- Fax
- (864) 433-0495
- NPI assigned
- Jun 25, 2021
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42917 | SC | MD | Local Education Agency (LEA) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 42917 | SC | Yes |
Addresses
Primary practice location
325 Inglesby Pkwy
Duncan, SC 29334-9117
Mailing address
325 Inglesby Pkwy
Duncan, SC 29334-9117
Phone (864) 433-8443
Other providers in Duncan, SC
- Chronic Health Solutions LLC
- Covenant Care Solutions, LLC
- Lori L Crawford
- Robert J Crockford
- Laura Elaine Curry
- Naporsha Davis
- Destination Dental LLC
- Destination Dental of Duncan LLC
- Jennifer D Dewyea
- Derek T Dunlap
All providers in Duncan, SC · Licensed Practical Nurse in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.