Individual
MRS. MEHGAN BLACKWELL LAZENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
550 S JACKSON ST DEPT ACB 1, LOUISVILLE, KY 40202-1622
(502) 561-7448
(502) 561-7480
Mailing address
550 S JACKSON ST DEPT ACB 1, LOUISVILLE, KY 40202-1622
(502) 561-7448
(502) 561-7480
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1-113065
AL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
10/29/2010
Last updated
05/02/2022
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