Healthcare Provider Details

I. General information

NPI: 1750251534
Provider Name (Legal Business Name): LAZ INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 MAYNARDVILLE HWY
MAYNARDVILLE TN
37807-3262
US

IV. Provider business mailing address

2975 MAYNARDVILLE HWY
MAYNARDVILLE TN
37807-3262
US

V. Phone/Fax

Practice location:
  • Phone: 865-658-5353
  • Fax: 865-658-5355
Mailing address:
  • Phone: 865-658-5353
  • Fax: 865-658-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LILLIA AFTON ZELLERS
Title or Position: FNP-C
Credential: FNP-C
Phone: 865-296-7044