Provider Demographics
NPI:1013372952
Name:HAYNES, LAURA E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:HAYNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1004 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-8720
Mailing Address - Country:US
Mailing Address - Phone:314-803-2352
Mailing Address - Fax:
Practice Address - Street 1:1013 CEDAR ST STE B
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:MO
Practice Address - Zip Code:63624-8901
Practice Address - Country:US
Practice Address - Phone:573-734-8588
Practice Address - Fax:888-626-5925
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2022-10-13
Deactivation Date:2022-10-02
Deactivation Code:
Reactivation Date:2022-10-13
Provider Licenses
StateLicense IDTaxonomies
MO2012023194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist