Individual
SUE T LAZARUS
Active
Individual
SUE T LAZARUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
2003031877
MO
176B00000X
Midwife
53-64037
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196105
ANTHEM
MO
05
—
200020120B
—
OK
05
—
200251050A
—
KS
05
—
200251050B
—
KS
05
—
259261105
—
MO
01
—
P00116412
RR MEDICARE
—
Enumeration date
07/05/2006
Last updated
07/29/2020
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