Healthcare Provider Details

I. General information

NPI: 1760295042
Provider Name (Legal Business Name): EDITH CLAIR LAZARO MSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EDITH CLAIR STANFIELD MSN RN

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 E 40TH ST
YUMA AZ
85365-7772
US

IV. Provider business mailing address

3006 W 11TH LN
YUMA AZ
85364-3347
US

V. Phone/Fax

Practice location:
  • Phone: 928-257-3760
  • Fax:
Mailing address:
  • Phone: 928-503-6985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN178081
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: