Jessica Lynn Lazzeri, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71002729A Issued in IN

Practice address

6913 N Main St
Granger, IN 46530-8039

Phone

(574) 647-6400

Fax

(574) 647-2951

NPI assigned

Nov 17, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1386899425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "address_2": "SUITE 300",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 N MAIN ST",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308039",
            "telephone_number": "574-647-6400",
            "fax_number": "574-647-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZERI",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71002729A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Granger, IN
• Providers in Granger, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.