Provider Demographics
NPI:1083195481
Name:FAKHOURY, NORA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:ELIZABETH
Last Name:FAKHOURY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 HAVERFORD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5331
Mailing Address - Country:US
Mailing Address - Phone:248-390-1435
Mailing Address - Fax:
Practice Address - Street 1:3251 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3635
Practice Address - Country:US
Practice Address - Phone:248-852-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist