Basic Information
| Provider Information | |||||||||
| NPI: | 1033549282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGRATH | ||||||||
| FirstName: | LACEY | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 308 N MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HAMPTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 506591142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413942151 | ||||||||
| FaxNumber: | 6413941999 | ||||||||
| Practice Location | |||||||||
| Address1: | 308 NORTH MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HAMPTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413942151 | ||||||||
| FaxNumber: | 6413941999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2013 | ||||||||
| LastUpdateDate: | 08/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A121520 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.