| Doctor Name: | MELISSA LACY |
| NPI Number: | 1356784748 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 17587 |
| Business Practice Address: | 189 Monroe Pl Ste 104 Ashland City, TN - 370154940 |
| Business Phone Number: | 8556323278 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1258, WAYNESBORO |
| State: | TN |
| Postal Code: | 384851258 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2013 |
| NPI Last Update Date: | 04/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 17587 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |