Lacey Caroline Gardner in Mount Pleasant - Physician Assistant

Lacey Caroline Gardner - NPI 1679758254

Lacey Caroline Gardner is a Physician Assistant in Mount Pleasant, Michigan. Lacey Caroline Gardner practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Lacey Caroline Gardner is 1679758254. The last update date is 2013-02-27.

Lacey Caroline Gardner's current location address is 1970 Ashland Dr, Mount Pleasant, Michigan. You can contact this provider via phone number 9897795262 and fax number 9897726784. The mailing address for Lacey Caroline Gardner is 1970 Ashland Dr, Mount Pleasant, Michigan. To know further, please read the information below!

Provider Profile Detail

Provider Name Lacey Caroline Gardner
Address 1970 Ashland Dr, Mount Pleasant, Michigan
Phone Number 9897795262
Fax Number 9897726784
Sole Proprietor N
Credentials PA-C

NPI Number Detail

NPI Number 1679758254
Provider Enumeration Date 2008-01-02
Last Updated Date 2013-02-27

Provider Mailing Address Detail

Address 1970 Ashland Dr
City Mount Pleasant
State Michigan (MI)
Post Code 488581203
Phone Number 9897795262
Fax Number 9897726784

Provider's Primary Taxonomy Detail

Speciality Physician Assistant
Taxonomy 363A00000X
Licence No 5601005080
Definition:
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
010Z960170 MI BLUE CROSS BLUE SHIELD
MI1118 MI MEDICARE GROUP NUMBER
080B610040 MI BCBS
0P43930 MI MEDICARE GROUP NUMBER
0Z96017 MI MEDICARE GROUP
0Z96017 MI MEDICARE PTAN

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FAQs about Lacey Caroline Gardner

What is the unique identification code assigned to Lacey Caroline Gardner by the Centers for Medicare & Medicaid Services?

The Lacey Caroline Gardner has been issued the NPI (National Provider Identifier) 1679758254. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).

Could you please share the complete physical location address where Lacey Caroline Gardner's facilities are situated?

The facilities of Lacey Caroline Gardner are physically located at the following address: 1970 Ashland Dr, Mount Pleasant, MI, 488581203.

What is the area of specialization for Lacey Caroline Gardner, and what is the corresponding taxonomy classification code for this field?

The specialized field of practice for Lacey Caroline Gardner is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.

On what date did the Centers for Medicare & Medicaid Services issue the 1679758254 to Lacey Caroline Gardner?

The Lacey Caroline Gardner received its 1679758254 assignment from the Centers for Medicare & Medicaid Services on 2008-01-02.

As of what date was the information pertaining to Lacey Caroline Gardner, such as address, specialty, and other details, last reviewed and confirmed to be accurate?

The information related to Lacey Caroline Gardner, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-02-27.

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