LACEY RENEE ANDERSON (NPI# 1669093175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669093175 |
| Entity Type | Individual |
| Full Name | LACEY RENEE ANDERSON |
| Other Name | LACEY RENEE GROFF |
| Credential | RN |
| Practice Address |
835 S Van Buren St Green Bay WI 54301-3526 |
| Mailing Address |
4228 Downton Cir Green Bay WI 54313-9110 |
| Practice Telephone | 4174999141 |
| Mailing Telephone | 4174999141 |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1726 Shawano Ave, Green Bay, WI 543033216 | 4174999141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275019671 | Lacey Paulett Anderson | Speech-Language Pathologist | 1101 Whispering Spring Ct, Burleson, TX 76028 | 2018-07-18 |
| 1790290450 | Lacey Snow Anderson | Speech-Language Pathologist | 1901 W 15th St, Edmond, OK 73013-2689 | 2017-12-04 |
| 1801306733 | Lacey Anderson | Psychologist | 4040 N Division St, Morris, IL 60450-9357 | 2017-10-05 |
| 1861872558 | Lacey Jo Anderson | Counselor | 25224 W. Eames St., Channahon, IL 60410-3102 | 2015-06-08 |
| 1346639267 | Lacey Anderson | Nurse Practitioner | 700 Medical Center Dr Ste 210, Newton, KS 67114-9017 | 2015-01-15 |
| 1568985943 | Lacey Anderson | Dietitian, Registered | 112 N 7th St, Chambersburg, PA 17201-1720 | 2017-07-18 |
| 1609290154 | Lacey Anderson | Behavioral Analyst | 4058 W Shady Plum Way, South Jordan, UT 84095-3908 | 2014-02-04 |
| 1306273461 | Lacey Anderson | Counselor | 2624 9th Ave S, Fargo, ND 58103-2350 | 2013-10-03 |
| 1912153727 | Lacey Dawn Anderson | Counselor | 530 San Pedro Ave, San Antonio, TX 78212-5006 | 2008-08-12 |
| Street Address |
835 S VAN BUREN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093707689 | Louis A Suarez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2005-08-18 |
| 1114526530 | Keisha Vickman | Nurse Practitioner | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-10-19 |
| 1902416480 | Tyler William Shimek | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-08-09 |
| 1770100489 | Fuad Emile Zankoul | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-06-29 |
| 1942822473 | Brittany Elizabeth Pitsch | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-05-06 |
| 1891320834 | Tarra Lynn Moran | Hospitalist | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-03-10 |
| 1780219238 | Shea A Sternhagen | Nurse Practitioner | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-03-05 |
| 1508490780 | Christopher Michael Robinson | Anesthesiology | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-02-26 |
| 1083250872 | Brandyn Robert Behnke | Registered Nurse | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2019-11-27 |
| 1306480157 | Devin Calaway | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2019-11-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205474905 | Nonglee Moua | Student in an Organized Health Care Education/Training Program | 345 Westplain Dr, Green Bay, WI 54303-3367 | 2019-12-13 |
| 1386138568 | Casey Gerald Deshambo | Student in an Organized Health Care Education/Training Program | 2100 Memorial Dr Apt 207, Green Bay, WI 54303-5309 | 2018-06-20 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1932632353 | Jacqueline Wanezek | Student in an Organized Health Care Education/Training Program | 2365 Donarski Ct, Green Bay, WI 54302-4329 | 2017-04-04 |
| 1013531656 | Michael Tadayuki Miyamoto | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-05-29 |
| 1184245326 | Kevin Michael Hansen | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-04-28 |
| 1689201832 | Ifeanyi Jeffrey Mbah | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-03-26 |
| 1689236531 | Heidi Marie Wennesheimer | Student in an Organized Health Care Education/Training Program | 1061 W Mason St, Green Bay, WI 54303-1858 | 2019-07-01 |
| 1942862982 | Nisa Keane Liberty | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2019-06-29 |
| 1053973123 | Kristin Nelson | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2019-06-28 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.