Search › Arkansas › 1041C0700X
Lacy Green
NPI 1174973150 · on the registry since 2016
Practice
- Address
- 1719 Merrill Dr
Little Rock, AR 72212 - Phone
- (501) 663-2199
- Fax
- (501) 663-2234
- Clinicians at this address
- 63
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 104100000X
- Licence states on file
- AR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-12-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arkansas