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Contact Information

ELLISA LACY, LPN
3435 N WOLVERINE DR
WASILLA, AK99654-2704
 Phone: 907-631-3830
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for ELLISA LACY · (Female)

NPI Number 1619319886
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 07/29/2013
Last updated 07/29/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 6962
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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