Provider Demographics
NPI:1174966980
Name:HOWARD, LACEY RENEA (DO)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:RENEA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:LACEY
Other - Middle Name:RENEA
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9195 GRANT ST STE 410
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9195 GRANT ST STE 410
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4388
Practice Address - Country:US
Practice Address - Phone:303-280-2229
Practice Address - Fax:303-280-0765
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0067123207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO029321OtherKAISER COMMERCIAL NUMBER
OK200584470BMedicaid
OK5570OtherMEDICAL LICENSE