Individual
MR. ANTONIO MARIA LAZCANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7000
Mailing address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23581
TN
363LA2100X
Acute Care Nurse Practitioner
23581
TN
Other
Enumeration date
11/12/2017
Last updated
04/07/2022
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