MRS. LACEY SULLIVAN, FNP-BC
Nurse Practitioner
Active
Individual
NPI: 1174951503
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner | 363L00000X | Yes | 2013037701 (MO) |
| Nurse Practitioner - Family | 363LF0000X | No | 2013037701 (MO) |
Frequently Asked Questions
NPI 1174951503 is the National Provider Identifier for MRS. LACEY SULLIVAN, FNP-BC, a Nurse Practitioner provider located in Bonne Terre, MO. This NPI was enumerated on October 22, 2013.
MRS. LACEY SULLIVAN, FNP-BC practices at 7245 RAIDER RD STE C, Bonne Terre, MO 63628.
Quick Facts
- NPI
- 1174951503
- Type
- Individual
- Enumerated
- Oct 22, 2013
- Last Updated
- Sep 17, 2025
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