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General NPI Number Information
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NPI Number | 1922705037
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Entity Type | Individual
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Provider Name | LAZINA PETERS
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Gender | Female
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 3180 N POINT PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4248
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Country | US
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Telephone | 770-559-8725
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Fax |
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Provider Business Mailing Address
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Address Line | 5835 REX RIDGE PKWY
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City | REX
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State | GA
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Zip | 30273-5223
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Country | US
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Telephone | 404-697-7855
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1266
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 211401
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License Number State | GA
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