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General NPI Number Information
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NPI Number | 1730593989
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Entity Type | Individual
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Provider Name | ERIN LAZENBY CPNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 36 PANTHER STADIUM DR
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City | PETAL
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State | MS
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Zip | 39465-3632
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Country | US
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Telephone | 601-450-2144
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Fax | 601-450-2145
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Provider Business Mailing Address
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Address Line | PO BOX 1729
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City | HATTIESBURG
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State | MS
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Zip | 39403-1729
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Country | US
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Telephone | 601-545-8700
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Fax | 601-255-2645
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN100625AP07799
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R852094
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License Number State | MS
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