LACY BACH (NPI# 1366813545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366813545 |
| Entity Type | Individual |
| Full Name | LACY BACH |
| Practice Address |
11445 Olive Blvd Creve Coeur MO 63141-7108 |
| Practice Telephone | 3144289543 |
| Practice Fax Number | 3144289542 |
| Mailing Telephone | 3144289543 |
| Mailing Fax Number | 3144289542 |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2019-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F09151278 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1111 W Pearce Blvd, Wentzville, MO 633851020 | 6368873020 |
| Street Address |
11445 OLIVE BLVD |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-7108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326278102 | Kemin Chen | Specialist | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2009-07-15 |
| 1679053813 | Ryan Matthew Shaffer | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2018-08-17 |
| 1275051971 | Amanda Michelle Baldwin | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141 | 2017-09-01 |
| 1659895266 | Luke Andrew Shoulders | Physician Assistant | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2017-07-26 |
| 1316353121 | Samantha Yates Nuckols | Physician Assistant | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2014-07-02 |
| 1750700928 | Marina Fischer | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2014-04-15 |
| 1043584634 | Nichole Marie Maclellan | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141 | 2012-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417516006 | Resolute Nursing Solutions LLC | Nurse Practitioner | 724 Questover Ln, Creve Coeur, MO 63141-6442 | 2019-06-07 |
| 1932618477 | Lauren Finnerty | Nurse Practitioner | 845 N New Ballas Ct Ste 120, Creve Coeur, MO 63141-7169 | 2017-09-27 |
| 1871966796 | Christine Ann Vaughan | Nurse Practitioner | 11560 Olive Blvd # 3087, Creve Coeur, MO 63141-7111 | 2015-11-02 |
| 1114534971 | Kristen Nicole Marino | Nurse Practitioner | 11560 Olive Blvd, Creve Coeur, MO 63141-7111 | 2020-09-25 |
| 1558977421 | Grace Marie Freeman | Nurse Practitioner | 10800 Olive Blvd, Creve Coeur, MO 63141-7773 | 2020-09-16 |
| 1225675291 | Claire Elizabeth Jensen | Nurse Practitioner | 11560 Olive Blvd, Creve Coeur, MO 63141-7111 | 2019-12-09 |
| 1407406986 | Colleen Michelle Dostal | Nurse Practitioner | 11550 Olive Blvd, Creve Coeur, MO 63141-7111 | 2019-09-16 |
| 1225681802 | Alecia Welvers | Nurse Practitioner | 11560 Olive Blvd, Creve Coeur, MO 63141-7111 | 2019-07-22 |
| 1679053813 | Ryan Matthew Shaffer | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141-7108 | 2018-08-17 |
| 1275051971 | Amanda Michelle Baldwin | Nurse Practitioner | 11445 Olive Blvd, Creve Coeur, MO 63141 | 2017-09-01 |
| Find all providers in CREVE COEUR | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on LACY BACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.