Individual
MR. JERRY WAYNE LAZERUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13291 HIGHWAY 67, MALVERN, AR 72104-7431
(501) 467-8061
Mailing address
13291 HIGHWAY 67, MALVERN, AR 72104-7431
(501) 467-8061
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R28178
AR
367500000X
Certified Registered Nurse Anesthetist
C00450
AR
Other
Enumeration date
12/12/2006
Last updated
09/11/2025
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