Provider Demographics
NPI:1093000697
Name:ZOHN, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ZOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 TIMBER DR E
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6913
Mailing Address - Country:US
Mailing Address - Phone:919-661-9598
Mailing Address - Fax:919-661-9598
Practice Address - Street 1:1040 TIMBER DR E
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6913
Practice Address - Country:US
Practice Address - Phone:919-661-9598
Practice Address - Fax:919-661-9598
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist