Provider Demographics
NPI:1568465706
Name:LAZARUS, ELIZABETH (CRNA, RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:CRNA, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2560
Mailing Address - Country:US
Mailing Address - Phone:619-246-8420
Mailing Address - Fax:760-994-1205
Practice Address - Street 1:3516 WOODLAND WAY
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2560
Practice Address - Country:US
Practice Address - Phone:619-246-8420
Practice Address - Fax:760-994-1205
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse