Provider Demographics
NPI:1437431400
Name:MITCHENER, LELIA ANN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LELIA
Middle Name:ANN
Last Name:MITCHENER
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 1:920 RICHLAND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3006
Mailing Address - Country:US
Mailing Address - Phone:919-522-0094
Mailing Address - Fax:
Practice Address - Street 1:300 VEAZEY DR
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1668
Practice Address - Country:US
Practice Address - Phone:919-764-5714
Practice Address - Fax:919-764-5720
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170841835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric