Individual ProviderKeegan LacyRegistered NurseNursing Service ProvidersPractice Address3131 E Camelback Rd Ste 200, Phoenix, AZ 85016-4599(480) 385-8733(480) 310-6908PECOS EnrollmentBased on the most recent information from CMS, provider Keegan Lacy does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1821487869Provider TypeIndividualFull NameLacy, KeeganCredentialRNGenderFemaleSole ProprietorNoEnumeration Date1/14/2015Last Updated1/14/2015Contact InformationPractice LocationPractice Address3131 E Camelback Rd Ste 200, Phoenix, AZ 85016-4599Phone(480) 385-8733Fax(480) 385-4930Mailing LocationMailing Address4725 E Brown Rd Unit 55, Mesa, AZ 85205-4737Phone(480) 310-6908FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN182772Arizona