Daniels, Lacretia M

Daniels, Lacretia M is an individual health care provider with primary practice located at 1520 Wentzville Pkwy , Wentzville MO 63385-3408. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Daniels, Lacretia M can be contacted via phone (636) 497-4055.

Contact Information

Primary practice address
1520 Wentzville Pkwy Wentzville MO 63385-3408
Phone: (636) 497-4055
Fax: (636) 344-1069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 137786 Missouri

Profile Details

NPI number 1518103654
LBN Legal business name Daniels, Lacretia M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2008
Last updated Sep 25th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518103654 NPPES
Missouri MEDICAID 427204102

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