Lacie Jae Boles
Community Health Worker in Shawnee, OK. Individual provider (NPI-1).
NPI number1831990381
StatusActive
Last updated in NPPESMar 21, 2025
Details
- NPI
- 1831990381
- Entity type
- Individual (NPI-1)
- Name
- Lacie Jae Boles
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2025
- Certification date
- Mar 21, 2025
- Last updated
- Mar 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
2307 Gordon Cooper DrShawnee, OK 74801-9007
Phone 405-214-5111
Mailing address
2307 Gordon Cooper DrShawnee, OK 74801-9007
Phone 405-214-5111
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Other Community Health Worker providers in Shawnee, OK
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- Cheyenne Rose MeadowsNPI 1124800685
- Lisa Marie WhiteNPI 1922916600
All 7 Community Health Worker providers in Shawnee · All 1,457 providers in Shawnee
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