LACEY KAY WILSON


Address: 3001 St Anthony Way, Pendleton, OR 97801
Phone: 5419660535

LACEY KAY WILSON (NPI# 1720455660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720455660
Entity Type Individual
Full Name LACEY KAY WILSON
Credential FNP
Practice Address 3001 St Anthony Way
Pendleton
OR 97801
Mailing Address 2801 St Anthony Way
Pendleton
OR 97801-3800
Practice Telephone 5419660535
Practice Fax Number 5412784597
Mailing Telephone 5419660535
Mailing Fax Number 5412784597
Enumeration Date 2015-08-26
Last Update Date 2019-02-21
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QR1300X Clinic/Center
Specialization: Rural Health
201506113NP-PP OR Ambulatory Health Care Facilities
Y 363LF0000X Nurse Practitioner
Specialization: Family
201506113NPPP OR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500717784 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
64198 Grays Corner Rd, Cove, OR 978248504 5418055050

Other Providers LACEY WILSON

NPI Name Taxonomy Address Enumeration
1447730981 Lacey Patricia Wilson Nurse Practitioner 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2018-08-15
1730616566 Lacey Wilson Counselor 1160 Camp St, New Orleans, LA 70130-4202 2017-05-11
1578001855 Lacey Wilson Licensed Practical Nurse 418 Colegate Dr, Marietta, OH 45750-9549 2017-02-07
1730541053 Lacey Wilson Occupational Therapist 9220 Kirby Dr Ste 1000, Houston, TX 77054-2534 2016-03-25
1740681394 Lacey Marie Wilson Counselor 1212 W Lombard St, Springfield, MO 65806-2720 2014-09-12
1336586601 Lacey Wilson Counselor 2626 Charles Dr, Chalmette, LA 70043-3779 2013-05-28

Office Location

Street Address 3001 ST ANTHONY WAY
City PENDLETON
State OR
Zip Code 97801

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972500296 William F Bell Orthopaedic Surgery 3001 St Anthony Way, Pendleton, OR 97801 2005-07-01
1073082046 Ashley Rae Christensen Registered Nurse 3001 St Anthony Way, Pendleton, OR 97801-3836 2018-11-19
1295197887 Katie C Morioka Nurse Practitioner 3001 St Anthony Way, #120, Pendleton, OR 97801-3836 2016-03-23
1457736977 Biana Manchik Family Medicine 3001 St Anthony Way, Pendleton, OR 97801 2015-07-27
1932511540 Andrew Schwartz Family Medicine 3001 St Anthony Way, Pendleton, OR 97801-3836 2014-05-30
1306260146 Providence Health & Services - Oregon Internal Medicine 3001 St Anthony Way, Pendleton, OR 97801-3836 2014-02-14
1639593387 Providence Health & Services - Oregon Internal Medicine 3001 St Anthony Way, Pendleton, OR 97801-3836 2014-02-14
1154520658 Wade Robert Hunsaker Nurse Practitioner 3001 St Anthony Way, Pendleton, OR 97801-3836 2007-07-13
1093912693 Aimee Elise Rogers Urology 3001 St Anthony Way, Pendleton, OR 97801 2007-06-28
1780880518 St Anthony Hospital Clinic/Center 3001 St Anthony Way, Pendleton, OR 97801-3836 2007-06-27
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720637119 Yvonne Walker Technician 821 Se 9th St, Pendleton, OR 97801 2019-09-09
1083262703 Praxis Medical Group Inc Family Medicine 2450 Sw Perkins Avenue, Pendleton, OR 97801 2019-08-27
1255826012 Cosmas Chukwuemeka Nwerem Jr. Pharmacist 1900 Sw Court Place, Pendleton, OR 97801 2018-06-25
1689166811 Helene Danielle Kuhn Counselor 4700 Nw Pioneer Pl, Pendleton, OR 97801 2018-06-04
1801302849 Shawna L. All Massage Therapist 24 Se Emigrant Ave., Pendleton, OR 97801 2017-12-27
1033649256 Sean Collins Pharmacist 203 Sw 20th St, Pendleton, OR 97801 2017-06-20
1073974796 Channon M Baker Peer Specialist 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 2016-03-08
1689034357 Carre Biegel Counselor 17 Sw Frazer St, Ste 282, Pendleton, OR 97801 2016-02-24
1073995429 Jessica Suzanne Pedersen Massage Therapist 812 Nw 12th St, Pendleton, OR 97801 2015-06-22
1861736373 Christina Northern Northerhn Social Worker 331 Se 2nd Street, Pendleton, OR 97801 2012-11-21
Find all providers in zip 97801

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700484631 Dana Marie Hampton Nurse Practitioner 2474 Sw Perkins Ave, Pendleton, OR 97801-4302 2020-10-13
1437789310 Marianne Beth Atkinson Nurse Practitioner 169 W Woodland Dr, Pendleton, IN 46064-9534 2020-01-20
1730610700 Whitney Owens Nurse Practitioner 1206 Pendle Hill Ave, Pendleton, IN 46064-9124 2017-03-22
1578960233 Lisa Ruth Johnson Nurse Practitioner 1312 Sw 2nd St, Pendleton, OR 97801-4160 2014-11-24
1477873487 Charlotte Anne Grover Branyon Nurse Practitioner 7611 Highway 76 Ste C, Pendleton, SC 29670-9162 2010-06-02
1386873982 Heidi A Miller Nurse Practitioner 2575 Westgate, Pendleton, OR 97801 2009-07-06
1346422235 Tracy Elizabeth Pozar Nurse Practitioner 702 Sw Dorion Ave, Pendleton, OR 97801-2039 2007-12-03
1801080619 Shannon Marie Johnson Nurse Practitioner 7900 Highway 76, Pendleton, SC 29670-8876 2007-09-05
1609904853 Debra Rae Frost Nurse Practitioner 715 Sw Dorion Ave, Pendleton, OR 97801-2070 2007-03-01
1952881898 Ashley Lavonne Astorga Nurse Practitioner 2500 Westgate, Pendleton, OR 97801-9606 2018-08-20
Find all providers in PENDLETON

Competitor

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City PENDLETON
Zip Code 97801

Improve Information

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Dataset Information

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.

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