Provider Demographics
NPI:1265704613
Name:LAZARINI, KRISTEN ASHLEY (MPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ASHLEY
Last Name:LAZARINI
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ASHLEY
Other - Last Name:CARGILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14044 W CAMELBACK RD STE 126
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-9492
Mailing Address - Country:US
Mailing Address - Phone:623-935-9600
Mailing Address - Fax:623-935-9602
Practice Address - Street 1:14044 W CAMELBACK RD STE 126
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-9492
Practice Address - Country:US
Practice Address - Phone:623-935-9600
Practice Address - Fax:623-935-9602
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07715363A00000X
AZ5683363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant