Provider Demographics
NPI:1427192574
Name:LAZENBY, DARLENE YVETTE (LVN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:YVETTE
Last Name:LAZENBY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3793 E HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-3602
Mailing Address - Country:US
Mailing Address - Phone:559-224-4969
Mailing Address - Fax:559-224-4969
Practice Address - Street 1:3793 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-3602
Practice Address - Country:US
Practice Address - Phone:559-224-4969
Practice Address - Fax:559-224-4969
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN162303164X00000X
CAVN1602303164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse