Provider Demographics
NPI:1427158096
Name:LAZAROFF, PATRICIA KELLY (RN, CNM, MSN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KELLY
Last Name:LAZAROFF
Suffix:
Gender:F
Credentials:RN, CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:58 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1044
Mailing Address - Country:US
Mailing Address - Phone:314-993-8518
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:MAILSTOP 90-21-400
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-454-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO062047367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife