Provider Demographics
NPI:1730593989
Name:LAZENBY, ERIN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:LAZENBY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 RICE MINE RD NE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2647
Mailing Address - Country:US
Mailing Address - Phone:205-614-5628
Mailing Address - Fax:
Practice Address - Street 1:4700 RICE MINE RD NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2647
Practice Address - Country:US
Practice Address - Phone:205-614-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN100625AP07799363LP0200X
MSR852094363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics