Provider Demographics
NPI:1255093779
Name:LAZARON, ERIN TERESE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:TERESE
Last Name:LAZARON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-2111
Mailing Address - Country:US
Mailing Address - Phone:781-664-8370
Mailing Address - Fax:
Practice Address - Street 1:36 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-2111
Practice Address - Country:US
Practice Address - Phone:781-664-8370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN88276164W00000X
MARN2359069163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse