Provider Demographics
NPI:1942025481
Name:OSTEEN, LACEY NICOLE (AGPCNP-C)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:NICOLE
Last Name:OSTEEN
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12127 WESTMERE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4021
Mailing Address - Country:US
Mailing Address - Phone:432-889-4425
Mailing Address - Fax:
Practice Address - Street 1:12127 WESTMERE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4021
Practice Address - Country:US
Practice Address - Phone:432-889-4425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1180267363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology