Gardner, Lacey Caroline

Gardner, Lacey Caroline is an individual health care provider with primary practice located at 1970 Ashland Dr , Mount Pleasant MI 48858-1203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gardner, Lacey Caroline can be contacted via phone (989) 779-5262.

Contact Information

Primary practice address
1970 Ashland Dr Mount Pleasant MI 48858-1203
Phone: (989) 779-5262
Fax: (989) 772-6784
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601005080 Michigan

Profile Details

NPI number 1679758254
LBN Legal business name Gardner, Lacey Caroline
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2008
Last updated Feb 27th, 2013 - about 13 years ago

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 1679758254 NPPES
Michigan Other 010Z960170 BLUE CROSS BLUE SHIELD
Michigan Other MI1118 BLUE CROSS BLUE SHIELD
Michigan Other 080B610040 BLUE CROSS BLUE SHIELD
Michigan Other 0P43930 BLUE CROSS BLUE SHIELD
Michigan Other 0Z96017 BLUE CROSS BLUE SHIELD
Michigan Other 0Z96017 BLUE CROSS BLUE SHIELD

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