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Contact Information

LACEY POE, APRN
3644 W ST HWY 18
SUITE B
MANILA, AR72442
 Phone: 870-561-3300
 Fax: 870-561-3307
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LACEY POE · (Female)

NPI # 1205069630
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 09/02/2009
Last updated 02/18/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • AR License # A03280
  • AR Medicaid 179499758
Hospital affiliation(s)
  • GREAT RIVER MEDICAL CENTER - (Acute Care)
    1520 N DIVISION STREET
    BLYTHEVILLE, AR 72315
  • NEA BAPTIST MEMORIAL HOSPITAL - (Acute Care)
    4800 EAST JOHNSON AVENUE
    JONESBORO, AR 72401
  • ST BERNARDS MEDICAL CENTER - (Acute Care)
    225 E JACKSON
    JONESBORO, AR 72401
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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