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Individual

MRS. MARY PATRICIA LAZAREK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2424 REEDIE DR, WHEATON, MD 20902-4624
(301) 962-6173
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-7405

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024066457
VA
363LF0000X
Family Nurse Practitioner
Primary
R103005
MD

Other

Enumeration date
11/16/2006
Last updated
06/02/2021
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