Provider Demographics
NPI:1265990451
Name:LAZARSKI, PAULA MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MICHELLE
Last Name:LAZARSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 LAUREL BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-1415
Mailing Address - Country:US
Mailing Address - Phone:570-628-5374
Mailing Address - Fax:570-628-5809
Practice Address - Street 1:1410 LAUREL BLVD STE 2
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-1415
Practice Address - Country:US
Practice Address - Phone:570-628-5374
Practice Address - Fax:570-628-5809
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN233114L163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management