Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN1033864 | DC |
NPI | 1033585054 |
---|---|
Provider Name | Lacey Edwards Hartz |
First Address | Baltimore, MD 21297-7215 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 13/08/2015 |