MEDICARE: MRS. ELIZABETH LAZARUS C.R.N.A, R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	556814	CA

General Provider Information

NPI Number	:	1568465706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH LAZARUS C.R.N.A, R.N.

Provider Business Mailing Address
First Line	:	3516 WOODLAND WAY
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-2560
Country	:	US
Telephone Number	:	619-246-8420
Fax Number	:	760-994-1205

Provider Business Practice Location Address
First Line	:	3516 WOODLAND WAY
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-2560
Country	:	US
Telephone Number	:	619-246-8420
Fax Number	:	760-994-1205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/08/2010

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