MS. LAURIE LEIGH LACKLAND (NPI# 1376895961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376895961 |
Entity Type | Individual |
Full Name | MS. LAURIE LEIGH LACKLAND |
Credential | ANP |
Practice Address |
1065 Ruth St Prescott AZ 86301-1729 |
Mailing Address |
Po Box 2104 Prescott AZ 86302-2104 |
Practice Telephone | 9287785655 |
Mailing Telephone | 8055061649 |
Enumeration Date | 2012-10-08 |
Last Update Date | 2014-07-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP4680 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1065 RUTH ST |
City | PRESCOTT |
State | AZ |
Zip Code | 86301-1729 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407890437 | The Evangelical Lutheran Good Samaritan Society | Home Health | 1065 Ruth St, Prescott, AZ 86301-4454 | 2006-06-16 |
1326238874 | The Evangelical Lutheran Good Samaritan Society | Hospice Care, Community Based | 1065 Ruth St, Suite 108-109, Prescott, AZ 86301 | 2007-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
Find all providers in zip 86301 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497086474 | Pamela Ann Akers | Nurse Practitioner | 1050 Gail Gardner Way 300, Prescott, AZ 86305-1640 | 2010-01-15 |
1164523098 | Suzann L Polk | Nurse Practitioner | 2940 Somerset Dr, Prescott, AZ 86305-5006 | 2006-09-25 |
1487755393 | Tana Bourdage-allman | Nurse Practitioner | Navahcs 550 North Highway 89, Prescott, AZ 86313 | 2006-09-25 |
1578671780 | Debra M Hiller | Nurse Practitioner | Navahcs Highway 89, Prescott, AZ 86313 | 2006-08-28 |
1811907058 | Bette Susan Zager | Nurse Practitioner | Northern Arizona Veteran Administration Health Care Sy, 500 N Hwy 89 (ecrc2), Prescott, AZ 86313 | 2006-08-09 |
1013959964 | Brenda A. Austin | Nurse Practitioner | 3212 N. Windsong Drive, Suite 200, Prescott, AZ 86305-3700 | 2006-06-12 |
1144610684 | Ryan Standage | Nurse Practitioner | 3108 Clearwater Dr, Ste A, Prescott, AZ 86305-7170 | 2015-02-04 |
1528402039 | Neuropathy and Pain Centre of Prescott LLC | Nurse Practitioner | 1000 Willow Creek Rd, Suite D, Prescott, AZ 86301-1645 | 2013-04-26 |
1124208558 | Lisa Santiago | Nurse Practitioner | 2100 Centerpointe West Dr, Prescott, AZ 86301-8487 | 2007-11-14 |
1104013580 | Carol Anne White | Nurse Practitioner | 500 N. Highway 89, Northern Arizona Va Hcs, Prescott, AZ 86314 | 2007-09-28 |
Find all providers in PRESCOTT |
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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.