Lacy Danielle Gulledge, ARNP in Jacksonville, FL

Lacy Danielle Gulledge, ARNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Jacksonville, Florida. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Integris Ambulatory Care Corporation and her current practice location is 15255 Max Leggett Pkwy, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 244-0411.

Lacy Danielle Gulledge is licensed to practice in Florida (license number ARNP9429348) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609387174.

Contact Information

	Lacy Danielle Gulledge, ARNP
	15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273
	(904) 244-0411
	Not Available

Map and Direction

Provider's Profile

Full Name	Lacy Danielle Gulledge
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	15255 Max Leggett Pkwy, Jacksonville, Florida
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lacy Danielle Gulledge graduated from nursing school in 2017

NPI Data:

NPI Number: 1609387174
Provider Enumeration Date: 10/23/2017
Last Update Date: 01/30/2018

Medicare PECOS Information:

PECOS PAC ID: 0941560049
Enrollment ID: I20250123000694

Medical Identifiers

Medical identifiers for Lacy Danielle Gulledge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609387174	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	ARNP9429348 (Florida)	Primary
363LA2100X	Nurse Practitioner - Acute Care	ARNP9429348 (Florida)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Integris Baptist Medical Center, Inc	Oklahoma city, OK	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Integris Ambulatory Care Corporation	2365408465	564

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lacy Danielle Gulledge allows following entities to bill medicare on her behalf.

Entity Name	Integris Ambulatory Care Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750333936 PECOS PAC ID: 2365408465 Enrollment ID: O20041209000354

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lacy Danielle Gulledge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lacy Danielle Gulledge, ARNP 75338 Ravenwood Dr, Yulee, FL 32097-1609 Ph: (334) 208-6190	Lacy Danielle Gulledge, ARNP 15255 Max Leggett Pkwy, Jacksonville, FL 32218-7273 Ph: (904) 244-0411

Reviews and Comments

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Mr. Jeffrey Ludan Vongjesda, M.S., APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3728 Philips Hwy Ste 34, Jacksonville, FL 32207 Phone: 904-399-2766 Fax: 904-549-8300

Lacy Danielle Gulledge, ARNP - Medicare Nurse Practitioner in Jacksonville, FL