Dr LISA R LACKEY is a female medical professional, specializing in Nurse Practitioner. She graduated in 2010.
CIBOLA GENERAL HOSPITAL CORPORATION
1423 E ROOSEVELT AVE
CIBOLA FAMILY HEALTH CENTER
GRANTS
NM
870202245
Tel: 5052876500
| Npi | 1104122647 |
| Pac Id | 8426209149 |
| Professional Enrollment Id | I20121106000370 |
| Last Name | LACKEY |
| First Name | LISA |
| Middle Name | R |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2010 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | CIBOLA GENERAL HOSPITAL CORPORATION |
| Group Practice Pac Id | 7113935891 |
| Number Of Group Practice Members | 23 |
| Line 1 Street Address | 1423 E ROOSEVELT AVE |
| Line 2 Street Address | CIBOLA FAMILY HEALTH CENTER |
| Marker Of Address Line 2 Suppression | |
| City | GRANTS |
| State | NM |
| Zip Code | 870202245 |
| Phone Number | 5052876500 |
| Hospital Affiliation Ccn 1 | 321308 |
| Hospital Affiliation Lbn 1 | CIBOLA GENERAL HOSPITAL |
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| Professional Accepts Medicare Assignment | Y |
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